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儿童B群链球菌耐药性分析及血清型分布

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目的 对儿童患者中分离的B群链球菌(GBS)耐药性及血清型进行分析,为防治儿童GBS感染及疫苗研发提供参考。方法 收集首都医科大学附属北京儿童医院2016年1月1日-2023年12月31日检出的不重复GBS 163株,进行菌株耐药性分析及血清型检测。结果 163株GBS中,侵袭性感染分离株121株,非侵袭性感染分离株42株。未发现对青霉素、头孢曲松、头孢吡肟、利奈唑胺和万古霉素耐药的菌株,对红霉素、克林霉素及左氧氟沙星的耐药率分别为91。4%、90。8%、53。4%,非侵袭性感染分离株对左氧氟沙星的耐药率高于侵袭性感染分离株。菌株血清型分布从高到低依次为:Ⅰb型75株(46。0%),Ⅲ型65株(39。9%),Ⅴ型13株(8。0%),Ⅰa型6株(3。7%),Ⅱ型2株(1。2%),Ⅳ型及Ⅵ型各1株(各占0。6%)。侵袭性感染分离株与非侵袭性感染分离株血清型分布差异有统计学意义(P<0。05),对红霉素和克林霉素耐药的GBS菌株血清型分布两组间差异均有统计学意义(均P<0。05),而对左氧氟沙星耐药的GBS菌株血清型分布两组间差异无统计学意义(P>0。05)。结论 北京地区儿童GBS感染菌株对红霉素和克林霉素耐药率较高,血清型以Ⅰb型及Ⅲ型较为常见,流行率高的血清型耐药率更高。持续监测GBS感染流行病学,对临床防治儿童GBS感染及疫苗研发至关重要。
Drug resistance and serotype distribution of Group B Streptococcus isola-ted from children
Objective To analyze the drug resistance and serotype of Group B Streptococcus(GBS)isolated from pediatric patients,provide reference for the prevention and treatment of GBS infection as well as vaccine develop-ment in children.Methods 163 non-repetitive GBS strains detected at Beijing Children's Hospital of Capital Medi-cal University from January 1,2016 to December 31,2023 were collected.Strains were conducted resistance analy-sis and serotype testing.Results Among the 163 GBS strains,121 and 42 were invasive and non-invasive infection isolates,respectively.No strains were found to be resistant to penicillin,ceftriaxone,cefepime,linezolid,and van-comycin,and resistance rates to erythromycin,clindamycin,and levofloxacin were 91.4%,90.8%,and 53.4%,re-spectively.Non-invasive infection isolates had a higher resistance rate to levofloxacin than invasive infection isolates.The distribution of bacterial serotypes from high to low was as follows:type Ⅰb(n=75,46.0%),type Ⅲ(n=65,39.9%),type Ⅴ(n=13,8.0%),type Ⅰa(n=6,3.7%),type Ⅱ(n=2,1.2%),type Ⅳ and Ⅵ(n=1,0.6%,each).There was a statistically significant difference in the distribution of serotypes between invasive and non-invasive infection isolates(P<0.05).Serotype distributions of erythromycin-and clindamycin-resistant GBS strains were both statistically different between two groups(both P<0.05),while serotype distribution of levoflo-xacin-resistant GBS strains was not statistically different between two groups(P>0.05).Conclusion GBS strains in children in Beijing have high resistance rates to erythromycin and clindamycin,with serotypes Ⅰb and Ⅲ being more frequent.Serotypes with high prevalence have higher resistance.Continuously monitoring on the epidemiology of GBS infection is crucial for the clinical prevention and treatment of GBS infection in children as well as the devel-opment of vaccines.

Group B Streptococcuschilddrug resistanceserotypeStreptococcus agalactiae

陈梅、董方、陈寰、甄景慧、孟庆盈

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国家儿童医学中心首都医科大学附属北京儿童医院检验中心,北京 100045

B群链球菌 儿童 耐药性 血清型 无乳链球菌

北京市自然科学基金项目

L232070

2024

中国感染控制杂志
中南大学

中国感染控制杂志

CSTPCD北大核心
影响因子:2.112
ISSN:1671-9638
年,卷(期):2024.23(10)