摘要
目的探讨肺炎链球菌流行的分布特征及其耐药性的变化趋势,为临床合理使用抗菌药物提供依据。方法回顾性分析2010年1月至2017年12月苏州大学附属儿童医院收集的呼吸道感染患儿痰标本中肺炎链球菌检出情况及其药物敏感试验结果。分别比较不同性别、年龄、年份和季节的肺炎链球菌检出率。采用Mann-Kendall趋势检验法分析肺炎链球菌年检出率及其对青霉素、阿莫西林和头孢噻肟的药物敏感性的变化趋势,采用季节性时间序列分解法分析肺炎链球菌检出率与季节的相关性。计数资料比较采用χ2检验。结果2010年至2017年共采集痰标本88480份,肺炎链球菌检出率为10.3%(9081/88480)。0~<0.5岁组、0.5~<2岁组、2~<3岁组、3~<5岁组、5~<15岁组患儿的肺炎链球菌检出率分别为4.2%(1407/33224)、13.1%(3191/24390)、14.9%(2417/16252)、17.9%(1474/8246)、9.3%(592/6368),各年龄组间肺炎链球菌检出率差异有统计学意义(χ^(2)=2421.6,P<0.01)。根据季度分组,1月至3月的检出率为8.1%(1321/16306),4月至6月为10.9%(2194/20207),7月至9月为8.5%(2141/25058),10月至12月为12.7%(3425/26909),比较差异有统计学意义(χ^(2)=311.5,P<0.01)。每年肺炎链球菌流行均有2个高峰和2个低谷。2010年至2017年检出的肺炎链球菌对青霉素、阿莫西林、头孢噻肟的耐药率呈逐年下降趋势,差异均有统计学意义(tau=-0.93、-0.93、-0.71,均P<0.05)。结论呼吸道感染儿童痰标本中肺炎链球菌的检出率可能存在季节性规律,不同年龄患儿检出率不同。肺炎链球菌对β-内酰胺类抗菌药物的耐药率有所下降。
Objective To explore the epidemiological characteristics and the antibiotic resistance of Streptococcus pneumoniae isolates,and to provide the evidence for the rational use of antimicrobial agents to treat Streptococcus pneumoniae infection.Methods The positive microbiological laboratory identification and antimicrobial susceptibility testing of Streptococcus pneumoniae from sputum of children with respiratory infections during January 2010 to December 2017 in Children′s Hospital of Soochow University were retrospectively analyzed.The positive rates of Streptococcus pneumoniae of different genders,ages,years and seasons were compared.The annual detection rates and trends of drug resistance of Streptococcus pneumoniae to penicillin,amoxicillin and cefotaxime were analyzed by Mann-Kendall trend test.The seasonal decomposition of time series was conducted to assess the association between Streptococcus pneumoniae detection rate and season.Enumeration data was compared using x^(2)test.Results Of the 88480 sputum specimens,the total positive rate of Streptococcus pneumoniae was 10.3%(9081/88480).The detection rates of Streptococcus pneumoniae in children aged 0 to<0.5 years old,0.5 to<2 years old,2 to<3 years old,3 to<5 years old,and 5 to<15 years old were 4.2%(1407/33224),13.1%(3191/24390),14.9%(2417/16252),17.9%(1474/8246)and 9.3%(592/6368),respectively.The difference was statistically significant(x^(2)=2421.6,P<0.01).The detection rates were 8.1%(1321/16306)from January to March,10.9%(2194/20207)from April to June,8.5%(2141/25058)from July to September,and 12.7%(3425/26909)from October to December.The discrepancy of positive rates in different seasons showed statistical significance(x^(2)=311.5,P<0.01).During 2010 to 2017,significant decreases in antibiotic resistant rates of Streptococcus pneumoniae to penicillin,amoxicillin and cefotaxime were detected(tau=-0.93,-0.93 and-0.71,respectively,all P<0.05).Conclusions The detection rate of Streptococcus pneumoniae in sputum of children with respiratory infections may present seasonal pattern and vary between different ages of children.The resistance toβ-lactam antibiotics has declined.
作者
刘长鹏
邵雪君
冯爽
陶云珍
王运中
薛建
严永东
田健美
赵根明
张涛
Liu Changpeng;Shao Xuejun;Feng Shuang;Tao Yunzhen;Wang Yunzhong;Xue Jian;Yan Yongdong;Tian Jianmei;Zhao Genming;Zhang Tao(School of Public Health,Fudan University,Shanghai 200032,China;Department of Clinical Laboratory,Children′s Hospital of Soochow University,Suzhou 215003,China;Department of Respiratory,Children′s Hospital of Soochow University,Suzhou 215003,China;Department of Infectious Diseases,Children′s Hospital of Soochow University,Suzhou 215003,China)
出处
《中华传染病杂志》
CAS
CSCD
2021年第2期97-102,共6页
Chinese Journal of Infectious Diseases
关键词
肺炎链球菌
检出率
时间序列
耐药性
Streptococcus pneumoniae
Positive rate
Time series analysis
Antibiotics resistance
