广州市区两幼儿园2～6岁健康儿童肺炎链球菌携带状况调查

Carrier Rate of Streptococcus Pneumoniae in Healthy Children Aged 2～6 in Two Kindergartens in Guangzhou City

摘要:

目的：了解广州市区两幼儿园2～6岁健康儿童肺炎链球菌携带状况及其对青霉素的药物敏感性。方法：对广州市区两家幼儿园220例健康儿童，用咽拭子从鼻咽部采集标本接种至血平板，35℃ 5% CO2 条件下孵育24 h，Optochin纸片确诊；琼脂板对倍稀释法测定青霉素最低抑菌浓度(MIC)。结果：220例健康儿童鼻咽部分离到肺炎链球菌53例，阳性率为 24.1%，49株对青霉素敏感(敏感率 92.5%)，4株中等度耐药(耐药率 7.5%)，其MIC依次为 0.125 mg/L，0.25 mg/L，0.25 mg/L和1 mg/L。肺炎链球菌分离阳性率与年龄关系较大：2～3岁及～4岁带菌率分别为 47.1%和 43.5%，～5岁带菌率为 21.4%，～6岁为 17.1%，不同年龄儿童带菌率差异有显著性(χ2=12.216，P<0.01)。不同班级分离阳性率亦存在差异，分离阳性往往集中出现在同一幼儿班。结论：2～6岁健康儿童肺炎链球菌带菌率较高，对青霉素的耐药率不高(7.5%)，为避免共同居住儿童交叉感染，对高带菌儿童实施疫苗接种是必要的。

Abstract:

OBJECTIVE: To investigate the carrier rate of streptococcus pneumoniae and the sensitivity to penicillin in children aged 2～6 in two kindergartens in Guangzhou City. METHODS: Pharyngo nasoparyngeal swab specimen were collected from 220 healthy children in two kindergartens in Guangzhou city. The swab was spread on the blood disk, cultured at 35℃, 5% CO2 for 24 h and identified by Optochin paper. The minimal inhibitory concentration of penicillin was measured by the agar dilution method. The positive rates of bacteria carrier were compared by using chi square test. RESULTS: Fifty three strains of streptococcus pneumoniae were isolated among 220 children (a carrier rate of 24.1%), 49 strains were sensitive to penicillin (a susceptibility rate of 92.5%) and 4 strains were moderately resistant to penicillin (a resistance rate of 7.5%). The positive rates were associated with age groups, especially the 2～4 years groups. The carrier rates of 2～3 years and ～4 years groups were 47.1% and 43.5% respectively, higher than those of ～5 years with 21.4% and ～6 years with 17.1%(χ2=12.216, P<0.01). The isolation rates were different in various classes and bacterial carriers usually gathered in the same class. CONCLUSIONS: Healthy children aged 2～6 have a high carrier rate of streptococcus pneumoniae. The resistant rate to penicillin is lower (7.5%). Children with a high carrier rate of streptococus pneumoniae must be immunized to avoid cross infection.