肺炎链球菌感染是一个主要的公共卫生问题,发病率和死亡率都很高。本研究旨在评估血清型分布,抗菌素耐药性的变化,克隆组合物,2000年至2021年中国东北地区肺炎链球菌分离株的毒力因子。共纳入1,454株肺炎链球菌分离株,有568个侵袭性菌株和886个非侵袭性菌株。分离肺炎链球菌的患者年龄从26天到95岁不等,≤5岁的人群占最大组(67.19%)。19F,19A,23F,14和6B是最常见的血清型,其中19A和19F是侵袭性和非侵袭性肺炎链球菌的主要血清型,分别。CC271是最常见的多位点序列类型。血清型14有最低的cbpA的表达,rrgA,和psrP基因,但19A和19F基因的表达水平相似。所有分离株对厄他培南敏感,莫西沙星,利奈唑胺,和万古霉素,但对大环内酯类药物具有高度抗性,四环素,和复方新诺明。同时对红霉素耐药,克林霉素,四环素,甲氧苄啶/磺胺甲恶唑是多重耐药分离株中的常见模式。非侵袭性肺炎链球菌对β-内酰胺类抗生素的耐药性高于侵袭性菌株。19A和19F是耐青霉素肺炎链球菌的主要菌株。与前一时期相比,2017年至2021年β-内酰胺类抗生素的耐药率下降。将PCV13纳入国家免疫规划可以有效降低肺炎球菌病的发病率和死亡率。
Streptococcus pneumoniae infection is a major public health concern with high morbidity and mortality rates. This study aimed to evaluate the serotype distribution, antimicrobial resistance changes, clonal composition, and virulence factors of S. pneumoniae isolates causing pneumococcal disease in northeast
China from 2000 to 2021. A total of 1,454 S. pneumoniae isolates were included, with 568 invasive strains and 886 non-invasive strains. The patients from whom the S. pneumoniae were isolated ranged in age from 26 days to 95 years, with those ≤ 5 years old comprising the largest group (67.19%). 19 F, 19 A, 23 F, 14, and 6B were the most common serotypes, of which 19 A and 19 F were the main serotypes of invasive and non-invasive S. pneumoniae, respectively. CC271 was the most common multilocus sequence type. Serotype 14 had the lowest expression of cbpA, rrgA, and psrP genes, but expression levels of 19 A and 19 F genes were similar. All isolates were sensitive to ertapenem, moxifloxacin, linezolid, and vancomycin but highly resistant to macrolides, tetracyclines, and cotrimoxazole. Simultaneous resistance to erythromycin, clindamycin, tetracyclines, and trimethoprim/sulfamethoxazole was common pattern among multidrug-resistant isolates. Non-invasive S. pneumoniae had higher resistance to β-lactam antibiotics than invasive strains. 19 A and 19 F were the main strains of penicillin-resistant S. pneumoniae. The resistance rate of β-lactam antibiotics decreased from 2017 to 2021 compared to previous periods. Including PCV13 in the national immunization program can reduce the morbidity and mortality rates of pneumococcal disease effectively.