Antimicrobial Resistance and Serotype Distribution of Streptococcus pneumoniae Strains in Central Taiwan

中台灣地區肺炎鏈球菌之藥敏型式與莢膜分型

呂旭峰(Hsu-Feng Lu) ； 鄒梅芬(Mei-Fen Tsou) ； 黃韶顏(Shau-Yen Huang) ； 施木青(Mu-Chin Shih) ； 施勇綸(Yung-Luen Shih) ； 張建國(Jan-Gowth Chang) ； 鄭庚申(Ken-Sheng Cheng)

《Mid-Taiwan Journal of Medicine》 5卷4期 (2000/12) Pp. 256-263

https://doi.org/10.6558/MTJM.2001.5(4).8

摘要

背景 肺炎鏈球菌抗藥性研究與血清分型，其對於藥物治療以及預防肺炎感染所推行之痘苗政策而言，扮演舉足輕重的角色。
方法 研究1998年1月至1999年12月期間在中台灣地區所分離出之77株肺炎鏈球菌之抗生素感受性試驗，並以哥本哈根之血清分型試劑測其莢膜腫脹試驗。所有受測的八種抗生素皆使用紙錠瓊酯擴散試驗，penicillin 則以E test 方法制其最低抑菌濃度，至於培養基則使用含5% defibrinated羊血的Mueller-Hinton。
結果 Penicillin 的抗藥性為68%、erythromycin為88%、tetracycline 為96％、chloramphenicol 為38％、trimethoprim/ sulfamethoxazole 為71 %，而vancomycin、cefotaxime、ceftriaxone 三者為0%。血清分型結果以第23型佔23%最高， 其次為第14 型佔18%，其餘依序為6 (17%)、9 (9%)、19 （8%）、3（8%）、4 (5%)、33 (3%)、15 (1%)、10 (1%)、17 (1%)、18 (1%)及20 (1%)。多重抗藥性菌株主要為血清型23 (90%)、14 (92%)、6 (92%)、9 (100%)、19(100% )、3 (67%)、4 (50%)。就疫苗有強性而言，進口疫苗可涵蓋97%常規所分離之肺炎鏈球菌。
討論 對penicillin其中間型與抵抗性菌株，對其他種抗生素會更具抗性。肺炎鏈球菌抗藥性問題相當嚴重。目前所使用23種疫苗血清型幾乎涵蓋大部份之分離菌，然而對於整體台灣之血清分型之分佈概況，仍須作更詳盡調查，以利對疫苗涵蓋率更進一步暸解。”

關鍵字

多重抗藥性 ； 血清分型 ； 效價性肺炎鏈球菌疫苗

並列摘要

Background. Antibiotic resistance and serotype distribution of Streptococcus pneumoniae have grown in importance due to the treatment and vaccine policy for pneumococcal infection in Taiwan.
Methods. From January 1998 through December 1999, we studied the susceptibilities and serotypes of 77 pneumococcal strains isolated in central Taiwan. Typing was carried out using detection of quellung reactions with antisera provided by the Staten Seruminstitut (Copenhagen, Denmark). All strains were initially screened for susceptibility to antimicrobial agents using the disk diffusion method d to penicillin using the E test method on Mueller-Hinton agar plates with 5% defibrinated sheep blood.
Results. Resistance rates were penicillin, 68%; erythromycin, 88%; tetracycline, 96%; chloramphenicol, 38%; vancomycin, 0%; cefotaxime, 0%; ceftriaxone, 0%; and trimethoprim/sulfamethoxazole, 71%. The serotypes were 23 (24%), 14 (18%), 6 (17%), 9 (9%), 19 (8%), 3 (8%), 4(5.%), 33 (3%), 15(1%),10 (1%), 17 (1%),18 (1%), and 20 (1%). Multiple drug resistance was associated with predominant serotypes of 23 (90%), 14 (92%), 6 (92%), 9 (100%), 19 (100%), 3 (67%), and 4(50%). Nearly 97% of all pneumococcal strains isolated in this surveillance belonged to one of the 21 different types or groups represented in the 23 valent-pneumococcal vaccine. Conclusions. Resistances to the tested antibodies were more common among intermediate penicillin-resistant isolate than among penicillin-susceptible isolates. Antimicrobial resistance among S. pneumoniae has become a serious problem. In addition, the 23-valent pneumococcal vaccine provided the potential efficacy for prevention of pneumococcal infections.

並列關鍵字

multiple drug resistance ； serotype ； valent-pneumococcal vaccin