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目的 了解北京地区儿童鼻部携带的肺炎链球菌对抗生素的敏感性以及血清型分布 ,分析鼻部携带青霉素非敏感肺炎链球菌的危险因素。方法 用纸片扩散法检测肺炎链球菌对红霉素 ,复方新诺明 ,氯霉素和四环素的敏感性 ;E -试验确定青霉素 ,头孢呋新 ,头孢噻肟 ,安灭菌和亚胺培南的最小抑菌浓度 ;Quellung反应确定肺炎链球菌的血清型。结果 未发现对青霉素和头孢呋新高度耐药的肺炎链球菌 ,但对青霉素和头孢呋新中度耐药的肺炎链球菌分别占 8 2 %和 2 1%。所有菌株均对头孢噻肟 ,安灭菌和亚胺培南敏感。对红霉素 ,复方新诺明和四环素耐药的肺炎链球菌特别多 ,分别占 72 % 70 %和 79%。所有肺炎链球菌中 ,有 5种血清型 (19,6 ,14 ,2 3,17)共占 5 4 7% ,不定型占 2 0 6 %。既往中耳炎病史是鼻部携带青霉素非敏感肺炎链球菌的危险因素。结论 连续监测肺炎链球菌对抗生素的敏感性具有重要意义。需要进行更大规模的研究以明确目前的 7价或 9价肺炎链球菌结合疫苗是否适合中国儿童
Objective To understand the antibiotic susceptibility and serotype distribution of S. pneumoniae carried by children’s nose in Beijing and to analyze the risk factors of nasal penile non-susceptible Streptococcus pneumoniae infection. Methods The susceptibility of Streptococcus pneumoniae to erythromycin, cotrimoxazole, chloramphenicol and tetracycline was determined by disk diffusion method. E - test was used to determine the sensitivity of penicillin, cefuroxime, cefotaxime, Southern minimum inhibitory concentration; Quellung reaction to determine the serotype of S. pneumoniae. RESULTS: Streptococcus pneumoniae highly resistant to penicillin and cefuroxime were not found, but moderately resistant to penicillin and cefuroxime were 8.2% and 21%, respectively. All strains were sensitive to cefotaxime, fenaza and imipenem. Erythromycin, cotrimoxazole and tetracycline resistant Streptococcus pneumoniae in particular are more, accounting for 72% 70% and 79%. Of all S. pneumoniae, 5 serotypes (19, 6, 14, 2, 3, 17) accounted for 54.7% of total, and unstructured forms accounted for 26%. The history of previous otitis media is a risk factor for nasal carriage of penicillin-non-sensitive Streptococcus pneumoniae. Conclusion Continuous monitoring of the susceptibility of Streptococcus pneumoniae to antibiotics is of great importance. Larger studies are needed to determine whether the current 7-valent or 9-valent pneumococcal conjugate vaccine is suitable for Chinese children