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目的了解保定市肺炎链球菌血清型和耐药性特征,指导临床用药。方法收集2013-2015年保定市3家医院临床分离的非重复性肺炎链球菌210株,对这些菌株采用多重PCR方法进行分型,再用K-B法判定药物的敏感性,分析不同血清型SP的耐药性。结果 210株肺炎链球菌菌型主要有4种,分别为血清型19F(30.0%)、19A(16.7%)、6A/6B(11.0%)、5(5.2%)。≤5岁年龄组患者PRSP(口服折点)的发生率最高达到48.4%,其阿莫西林耐药率高于其他年龄组(20.0%、17.6%),差异有统计学意义(χ2=6.103,P<0.05)。不同年龄组对氟喹诺酮类药物都保持很高的敏感率(100.0%)。血清型19F和19A的PNSP菌株对阿莫西林、头孢曲松的不敏感率显著大于PSSP菌株(P<0.05);19F、19A、6A/6B和5型对美罗培南的不敏感率PNSP菌株均显著大于PSSP菌株(P<0.05)。左氧氟沙星、氧氟沙星、万古霉素、莫西沙星对各血清型都有很高的敏感性。结论目前SP耐药形式严峻,应及时监控肺炎链球菌的血清分型和耐药性变化。
Objective To understand the serotype and drug resistance of Streptococcus pneumoniae in Baoding and to guide the clinical medication. Methods Two hundred and seventy non-repetitive S. pneumoniae isolates were collected from three hospitals in Baoding city from 2013 to 2015. The strains were genotyped by multiplex PCR. The drug susceptibility was determined by KB method. Resistance. Results The results showed that there were 4 main bacterial strains of 210 Streptococcus pneumoniae, which were serotype 19F (30.0%), 19A (16.7%), 6A / 6B (11.0%) and 5 (5.2%) respectively. The incidence rate of PRSP (oral convalescence) in patients ≤5 years old was the highest (48.4%), the amoxicillin resistant rate was higher than other age groups (20.0%, 17.6%), the difference was statistically significant (χ2 = 6.103, P <0.05). Fluoroquinolones maintained high sensitivity (100.0%) in different age groups. The insensitivity rates of amoxicillin and ceftriaxone to serogroup 19F and 19A PNSP strains were significantly higher than that of PSSP strains (P <0.05). The insensitivity rates of 19, 19A, 6A / 6B and 5 strains to meropenem were Significantly greater than PSSP strains (P <0.05). Levofloxacin, ofloxacin, vancomycin, and moxifloxacin are highly sensitive to each serotype. Conclusion At present, the form of SP resistance is severe, and the serotype and drug resistance of Streptococcus pneumoniae should be monitored in time.