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目的了解广州地区婴幼儿B族链球菌(GBS)的血清型分布特点及其耐药情况。方法按照《临床检验操作规程》对3岁以下婴幼儿临床送检标本进行分离培养,用Vitek 2 Compact全自动细菌鉴定系统对所分离的B族链球菌进行鉴定及抗生素最小抑菌浓度(MIC)测定,分析耐药情况,并对菌株进行血清学分型,用WHONET-5.6进行数据分析。结果共检出108株B族链球菌,其中分离自7 d以内的新生儿50株,分离自7 d~3个月的婴儿49株,分离自3个月~3岁的幼儿9株。108株GBS可分为6个血清型,其中Ia、Ⅲ型为早发型感染的主要血清型,Ⅲ型为晚发型感染的主要致病血清型。对检出的108株GBS药敏结果显示:100%GBS对青霉素类、头孢菌素类、万古霉素、利奈唑烷、呋喃妥因敏感,对左氧氟沙星、克林霉素、红霉素、四环素的耐药率分别为12.2%、55.6%、78.9%、88.5%。结论血清型分型结果对我国进一步研究荚膜多糖疫苗进行GBS免疫预防感染有重要意义,对婴幼儿GBS进行连续药物敏感监测、准确报告药敏结果对于指导临床医师合理选用抗生素也提供了重要的理论依据。
Objective To understand the serotype distribution and drug resistance of B-streptococci (GBS) in Guangzhou area. Methods According to the “Clinical Laboratory Procedures”, clinical samples from infants under 3 years of age were isolated and cultured. The Vibrio group B streptococci were identified by Vitek 2 Compact automatic bacterial identification system and the MIC of antibiotics Determination, analysis of drug resistance, and serological typing of strains, with WHONET-5.6 for data analysis. Results A total of 108 strains of Streptococcus group B were detected, including 50 newborns isolated within 7 days, 49 infants separated from 7 d to 3 months and 9 infants separated from 3 months to 3 years old. 108 strains of GBS can be divided into 6 serotypes, of which Ia, Ⅲ type of early-onset infection of the major serotypes, Ⅲ type late-onset infection of the main pathogenic serotypes. The susceptibility of 108 GBS isolates detected showed that 100% GBS was sensitive to penicillins, cephalosporins, vancomycin, linezolid and nitrofurantoin, to levofloxacin, clindamycin, erythromycin and tetracycline Drug rates were 12.2%, 55.6%, 78.9%, 88.5%. Conclusions The results of serotyping are of great significance for further study of GBS immunoprophylactic infection in our country. Continuous drug sensitivity monitoring of GBS in infants and young children and accurate reporting of drug susceptibility results also provide important guidance for clinicians in selecting appropriate antibiotics Theoretical basis.