Abstract
Objective: The objective is to analyze the seroepidemiology and resistance of Streptococcus pneumoniae in children over 5 y.o.Methods: 57 patients with pneumonia and 186 healthy children were examined. The induced sputum and nasopharyngeal swabs were analyzed with culture and molecular assays.Results: S. pneumoniae incidence among healthy children was 15.1 %. Serotype flora was represented by 4 serotypes and 6 serogroups with prevalence of 19F, 37 (for 17.8 % each), 6АВС, 3 (for 10.7 % each). 17.8 % of strains were antibiotic resistant, four of them was 19F serotype, and one was of the 6th serogroup. All of them were multiresistant: to macrolides, lincosamides, tetracyclines, cephalosporins of II generation along with moderate resistance to penicillin. In children with pneumonia, pneumococcocus was detected in 24.6 % of cases: serotypes 19F (64.3 %), 19А (21.4 %), 23F (14.3 %). 57.1 % of strains were multiresistant and was of 19F and 19А serotypes. Phenotype of the resistance was identic to the described above except the resistance to amoxicillin: all strains were resistant to it. All given isolates were moderately resistant to ceftriaxone.Conclusions: Serotype flora of pneumococci in healthy children of school age was distinct in significant variety with high incidence of ‘mucoid’ serotypes 3 and 37 (28.6 %). In pneumonia, pneumococci of 19F and 19A types occurred significantly frequently. The main resistant serotype of S. pneumoniae in both groups was 19F with lowered sensitivity to beta-lactam antibiotics.
Highlights
В то же время, в этой возрастной группе внебольничная пневмония – достаточно часто встречающееся заболевание
В то же время, при внебольничной пневмонии достоверно чаще обнаруживались представители типов 19F и 19A, что свидетельствует о более высокой их вирулентности
URL: http:// www.eucast.org/clinical_breakpoints/ (Accessed: November 6, 2018)
Summary
Цель: анализ сероэпидемиологии и резистентности Streptococcus pneumoniae у детей старше 5 лет. Обследовано 57 больных пневмонией и 186 здоровых детей. Частота встречаемости S. pneumoniae среди здоровых детей составила 15,1 %. Все они были мультирезистентными: к макролидам, линкозамидам, тетрациклинам, цефалоспоринам II поколения при умеренной устойчивости к пенициллину. У детей с пневмонией пневмококк был выделен в 24,6 % случаев: серотипы 19F (64,3 %), 19А (21,4 %), 23F (14,3 %). Фенотип резистентности был идентичен вышеописанному за исключением чувствительности к амоксициллину: все штаммы были к нему резистентны. Серотиповой пейзаж пневмококков у здоровых детей школьного возраста отличался значительным разнообразием с высокой частотой встречаемости «мукоидных» серотипов 3 и 37 (28,6 %). Эпидемиология серотипов пневмококка у детей с внебольничной пневмонией и носителей в г. Krasnoyarsk State Medical University named after prof.
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