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目的了解北京地区肺炎链球菌的耐药性以及青霉素耐药株的分子流行病学特征。方法１９９７年９～１１月采集北京市８所幼儿园９８５名儿童鼻咽拭子标本，分离培养肺炎链球菌，用Ｅｔｅｓｔ法和琼脂稀释法测定菌株对１２种抗生素的最低抑菌浓度（ＭＩＣｓ），用“荚膜肿胀”技术测血清分型，并用盒式聚合酶链反应（ＢＯＸＰＣＲ）分析青霉素耐药株的亲缘关系。结果儿童鼻咽部肺炎链球菌携带率为２４８％（２４４／９８５）。Ｅｔｅｓｔ法和琼脂稀释法的一致性＞９３７％。（１３１％）（３２／２４４）的菌株低耐青霉素ＭＩＣｓ（００９～０．２５）ｍｇ／Ｌ，３株（１２％）为高耐ＭＩＣｓ，３ｍｇ／Ｌ。青霉素敏感株对其它４种β内酰胺类都敏感。青霉素不敏感组中，１１４％（４／３５）的菌耐其它β内酰胺类。红霉素、四环素、氯环素、甲氧苄啶、磺胺异唑的耐药率分别为７４０％、８７６％、４７８％、６３３％。同时耐氯霉素、红霉素、四环素、甲氧苄啶、磺胺异恶唑的菌株占４８７％。所有菌株对万古霉素、利福平敏感。最常见的血清型为６Ａ（３３６％）、１９Ｆ（１６８％）、２３Ｆ（１５１％）、１５（１１２％）、６Ｂ（４３％）。３５株青霉素不敏感株?
Objective To understand the drug resistance of Streptococcus pneumoniae in Beijing and the molecular epidemiology of penicillin-resistant strains. Methods From September to November 1997, 985 children from 8 kindergartens in Beijing were collected for nasopharyngeal swab specimens. Streptococcus pneumoniae were isolated and cultured. The minimum inhibitory concentrations (MICs) of 12 strains of antibiotics were determined by Etest and agar dilution. Serum type was determined by “capsular swelling” technique, and the relationship between penicillin-resistant strains was analyzed by cassette PCR (BOX-PCR). Results The prevalence of S. pneumoniae in children was 248% (244/985). Etest method and agar dilution method of consistency> 93 7%. (131%) (32/244) strains were low resistant to penicillin MICs (009 ~ 0.25) mg / L and 3 strains (12%) were highly resistant to MICs and 3 mg / L. Penicillin-sensitive strains of the other four kinds of β-lactams are sensitive. In the penicillin-insensitive group, 11.4% (4/35) of the bacteria were resistant to other β-lactams. The resistance rates of erythromycin, tetracycline, chlorocycline, trimethoprim and sulfamethoxazole were 740%, 876%, 478% and 633%, respectively. While resistant to chloramphenicol, erythromycin, tetracycline, trimethoprim, sulfisoxazole strains accounted for 48 7%. All strains are sensitive to vancomycin and rifampicin. The most common serotypes were 6A (33.6%), 19F (16.8%), 23F (15.1%), 15 (11.2%), and 6B (4.3%). 35 strains of penicillin insensitive?