摘要
目的了解湖北省不同年龄组健康人群鼻咽部携带肺炎链球菌状况.分析其对常用抗生素的耐药特点.为预防肺炎链球菌感染和合理利用抗生素提供参考。方法采集的5个年龄组406名健康人群咽拭子,接种于哥伦比亚血平板培养基,进行肺炎链球培养;对分离的疑似肺炎链球菌菌株进行革兰染色、奥普托辛试验及胆汁溶解试验,并采用荧光PCR检测lytA基因确认为肺炎链球菌;采用纸片扩散法对分离菌株进行12种抗生素药物敏感性检测。结果 406份咽拭子中共培养出76株肺炎链球菌,总阳性携带率为18.72%,以3~5岁年龄组携带率最高（30.50%）,≥20岁年龄组携带率最低（4.76%）;对12种抗生素的药敏检测结果显示,76株肺炎链球菌菌株除对利福平和亚胺培南的敏感率达100%,对其他10种抗生素的敏感性均有不同程度的降低,敏感率依次为左旋氧氟沙星（98.68%）、青霉素（92.11%）、头孢曲松（85.53%）、头孢噻肟（82.89%）、氯霉素（81.58%）、环丙沙星（42.11%）、甲氧苄啶/磺胺甲恶唑（35.53%）、克林霉素（21.05%）、红霉素（17.11%）、阿齐霉素（15.79%）,同时对3种及以上抗生素耐药的菌株数高达82.89%（63/76）。结论湖北省健康人群鼻咽部肺炎链球菌携带以3~5岁年龄组为主,今后应重视该人群的带菌监测和疾病预防;本地区肺炎链球菌对常用抗生素耐药现象严重,建议临床上根据药敏结果选择有效抗生素治疗和预防感染。
Objective To understand the Streptococcus pneumoniae carrying status （Sp） in the healthy population, and analyze the antibiotic-susceptibility of the isolated Sp strains against the commonly used drugs, so as to provide information to improve treatment and prevention of Sp infection. Methods Four hundred and six nasopharyngeal swab samples from healthy people, aged 0 to 56 years were collected, and cultured on MH blood agar containing 2. 5 mg/L Gentamicin. Suspected Sp colonies were identified with Gram stain, Optochin test, bile solubility test and Real-time PCR targeting lytA gene. Kirby-Bauer disk diffusion antibiotic susceptibility against 12 commonly used drugs was performed on the isolated Sp strains. Results Seventy-six Sp strains were isolated from the 406 nasopharyngeal swab samples. The total positive rate was 18. 72%,with the highest,as 30. 50% in 3-5 years old group,and the lowest,as 4. 76% in I〉20 years old group. All the isolated Sp strains were sensitive to Rifampicin and Imipenem. The rate of antibiotic susceptibility was 98.68%, 92. 11%, 85.53%, 82. 89%, 81.58%, 42. 11%, 35.53%, 21.05%, 17. 11% and 15.79% to Levofloxacin, Penicillin, Ceftfiaxone, Cefotaxime, Chloramphenicol, Ciprofloxacin, Sulfamethoxazole/trimethoprim, Clindamycin, Erythromycin, Azithromycin,respectively. There were isolates （82. 89%） resistant to more than three drugs. Conclusion In Hubei province, the Sp carrying rate in children aged 3-5 years was the highest, therefore, more attention should be paid to this group. The antibiotic resistance of Sp strains isolated in the local region was common. It is suggested that clinician should choose drugs carefully according to the antibiotic-susceptibility testing results.
出处
《公共卫生与预防医学》
2014年第3期20-23,共4页
Journal of Public Health and Preventive Medicine
基金
湖北省卫生厅2013年基金项目(JX6B23)
卫生部与WHO流脑与乙脑监测(AMES)合作项目
关键词
肺炎链球菌
健康带菌
荧光PCR
药物敏感性
Streptococcus pneumoniae
Carrying status
Real-time PCR
Antibiotic-susceptibility
