【摘要】 目的 探讨肺炎链球菌（SP）的临床特点、血清分型与耐药性分析，为临床治疗提供依据。方法 收集青岛大学附属泰安市中心医院2019年1月至12月送检的各类标本类型中分离出的SP，药敏试验采用纸片扩散法和浓度梯度法（E-test），血清分型采用荚膜肿胀试验，统计分析疫苗对血清型的覆盖情况。结果 共收集104株肺炎链球菌，标本以痰液为主，占83.65%(87/104)。患者以6岁以下婴幼儿为主，占65.38%(68/104)。青霉素的敏感率为100.00%，对左氧氟沙星和氯霉素的敏感率高（>92.00%），但对红霉素、克林霉素和四环素高度耐药（>92.00%），未发现对头孢曲松、美罗培南、万古霉素、利奈唑胺和莫西沙星耐药的菌株。共分为18个血清型，常见的血清型19F、19A、6B和6A。肺炎链球菌疫苗的覆盖率：PCV13为82.69%,PPV23为89.42%。四种常见的血清型对抗菌药物的耐药率没有明显差异。结论 该院肺炎链球菌感染多见于婴幼儿，血清型以19F、19A、6B和6A为主。PCV13和PPV23疫苗的覆盖率高，值得推广应用。更多还原

【Abstract】 Objective To investigate the clinical characteristics, serotypes and drug resistance of Streptococcus pneumoniae(S. pneumoniae), and to provide the basis for clinical treatment. Methods S. pneumoniae was isolated from various specimens at the Affiliated Taian City Central Hospital of Qingdao University from January to December of 2019. Drug sensitivity tests were determined using the disk diffusion method and concentration gradient method(E-test), serological tests were carried out by capsule swelling test. The coverage of vaccine to serotype was analyzed statistically. Results A total of 104 S. pneumoniae samples were collected with sputum being the most common specimen, accounting for 83.65%(87/104). 65.38%(68/104) of the patients were under 6 years old. The sensitivity rate of penicillin was 100.00%, while the sensitivity rates of levofloxacin and chloramphenicol were high(> 92.00 %). However, the resistance rates of erythromycin, clindamycin and tetracycline were also high(> 92.00 %). No resistant strains were found for ceftriaxone, meropenem, linezolid, vancomycin and moxifloxacin. They were divided into 18 serotypes. The common serotypes were 19F, 19A, 6B, and 6A. The coverage of the S. pneumoniae vaccine was 82.69 % for PCV13 and 89.42 % for PPV23.There was no significant difference in the resistance rate to antibiotics among the four common serotypes. Conclusion The most common S. pneumoniae infections occur in infants and young children. The major serotypes are 19F, 19A, 6B, and 6A. The coverage of PCV13 and PPV23 vaccines is high and deserving of promotion.更多还原