单位：[1]Department of Clinical Laboratory, Peking University Peoples Hospital,Beijing 100044, China[2]Department of Clinical Laboratory, SouthwestHospital, Chongqing, China[3]Department of Clinical Laboratory, The FirstAffiliated Hospital of Xinjiang Medial University, Ürümqi, China[4]Departmentof Clinical Laboratory, Huazhong University of Science and TechnologyTongji Medical College Affiliated Pu Ai Hospital, Wuhan, China[5]Departmentof Clinical Laboratory, Zhongshan Hospital, Fudan University, Shanghai,China[6]Department of Clinical Laboratory, Tianjin Medical University GeneralHospital, Tianjin, China[7]Department of Clinical Laboratory, The First AffiliatedHospital of Sun Yat-sen University, Guangzhou, China东院检验科中山大学附属第一医院[8]Department ofClinical Laboratory, Peking Union Medical College Hospital, Beijing, China[9]Department of Clinical Laboratory, The Second Affiliated Hospital of MedicalSchool of Zhejiang University, Hangzhou, China[10]Department of ClinicalLaboratory, China-Japan Friendship Hospital, Beijing, China[11]Department ofClinical Laboratory, Guangzhou Institute of Respiratory Disease, GuangzhouMedical University, Guangzhou, China[12]Department of Clinical Laboratory,General Hospital of Ningxia Medical University, Yinchuan, China[13]Department of Clinical Laboratory, Jiangsu Provincial Peoples Hospital,Nanjing, China[14]Department of Clinical Laboratory, Shengjing Hospital ofChina Medical University, Shenyang, China中国医科大学附属盛京医院[15]Department of ClinicalLaboratory, China-Japan Union Hospital of Jilin University, Changchun, China吉林大学中日联谊医院[16]Department of Clinical Laboratory, The First Affiliated Hospital of MedicalSchool of Zhejiang University, Hangzhou, China浙江大学医学院附属第一医院[17]Department of ClinicalLaboratory, Shandong Provincial Hospital, Jinan, China[18]Department ofClinical Laboratory, Affiliated Hospital of Inner Mongolia Medical College,Hohhot, China[19]Department of Clinical Laboratory, Xijing Hospital, Xi’an,China[20]Department of Clinical Laboratory, Xiangya Hospital, Central SouthUniversity, Changsha, China[21]Department of Clinical Laboratory, BeijingTsinghua Chang Gung Hospital, Beijing, China[22]Department of ClinicalLaboratory, Shanghai Jiaotong University Affiliated Ruijin Hospital, Shanghai,China[23]Department of Clinical Laboratory, The First Affiliated Hospital ofGuangxi Medical University, Nanning, China
Background: Streptococcus pneumoniae, the leading pathogen of bacterial infections in infants and the elderly, is responsible for pneumococcal diseases with severe morbidity and mortality. Emergence of drug-resistant strains presented new challenges for treatment and prevention. Vaccination has proven to be an effective means of preventing pneumococcal infection worldwide. Detailed epidemiological information of antibiotic susceptibilities and serotype distribution will be of great help to the management of pneumococcal infections. Methods: A total of 881 S. pneumoniae isolates were collected from patients at 23 teaching hospitals in 17 different cities from 2011 to 2016. The main specimen types included sputum, blood, broncho-alveolar lavage fluid, pharyngeal swabs, and cerebrospinal fluid. Minimum inhibitory concentrations (MICs) were determined using the agar dilution method. Capsular serotypes were identified using latex agglutination and quellung reaction test. Molecular epidemiology was investigated using multilocus sequence typing. Results: S. pneumoniae isolates were highly resistant to macrolides, tetracycline, and trimethoprim/sulfamethoxazole. The rate of resistance to penicillin was 51.6% (oral breakpoint). However, levofloxacin and moxifloxacin maintained excellent antimicrobial activity and all of the isolated strains were susceptible to vancomycin. Twenty-two serotypes were identified among the 881 isolates. Prevalent serotypes were 19F (25.7%), 19A (14.0%), 15 (6. 8%), 6B (3.6%), 6A (3.0%), and 17 (2.8%). The overall vaccine coverage rates for 7 and 13 valent pneumococcal conjugate vaccines were 37.5% and 58.3%, respectively. Vaccine coverage rates in young children and economically underdeveloped regions were higher than those in older adults and developed regions. Vaccine-covered serotypes demonstrated higher resistance compared with uncovered serotypes. Molecular epidemiological typing demonstrated that S. pneumoniae showed significant clonal dissemination and that ST271 (120, 28.3%), ST320 (73, 17.2%) and ST81 (27, 6.6%) were the major STs. Conclusions: High resistance to clinical routine antibiotics was observed for all 881 S. pneumoniae strains. Drug resistance varied among different serotypes and age groups. Prevalent serotypes among the isolates were 19F, 19A, 15, 6B, 6A, and 17. Community-acquired strains should also be included in future studies to gain a better understanding of the prevalence and resistance of S. pneumoniae in China.
基金：
National Natural Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [81401695, 81625014]
第一作者单位：[1]Department of Clinical Laboratory, Peking University Peoples Hospital,Beijing 100044, China
共同第一作者：
通讯作者：
推荐引用方式(GB/T 7714)：
Zhao Chunjiang,Li Zongbo,Zhang Feifei,et al.Serotype distribution and antibiotic resistance of Streptococcus pneumoniae isolates from 17 Chinese cities from 2011 to 2016[J].BMC INFECTIOUS DISEASES.2017,17:doi:10.1186/s12879-017-2880-0.
APA：
Zhao, Chunjiang,Li, Zongbo,Zhang, Feifei,Zhang, Xiaobing,Ji, Ping...&Wang, Hui.(2017).Serotype distribution and antibiotic resistance of Streptococcus pneumoniae isolates from 17 Chinese cities from 2011 to 2016.BMC INFECTIOUS DISEASES,17,
MLA：
Zhao, Chunjiang,et al."Serotype distribution and antibiotic resistance of Streptococcus pneumoniae isolates from 17 Chinese cities from 2011 to 2016".BMC INFECTIOUS DISEASES 17.(2017)
