Objective: To investigate the serotype distribution and antimicrobial susceptibility pattern of Streptococcus pneumoniae (S. pneumoniae), Haemophilus influenzae (H. influenzae) and Moraxella catarrhalis (M. catarrhalis) isolates collected from nasopharyngeal swabs from Uygur children in Kashi. Methods: Nasopharyngeal swabs were collected from inpatient Uygur children aged from 1 month to 5 years with respiratory infections from the pediatric department, the First People's Hospital of Kashi, Xinjiang Uygur Autonomous Region. Antimicrobial susceptibilities of the isolates were determined with E-test and KB disk diffusion methods. The production of β-lactamase was detected for H. influenzae and M. catarrhalisisolates using nitrocefin disc method. Quellung test and latex agglutination test were adopted to identify serotypes of S. pneumoniae and H. influenzae isolates. Results: Forty-seven S. pneumoniae, 13 H. influenzae and 16 M. catarrhalis isolates were detected. All of the 47 S. pneumoniae isolates were sensitive to parenteral penicillin, amoxicillin-clavulanic acid, vancomycin and levofloxacin; the susceptibility rates to cefotaxime, imipenem and chloramphenicol were 94% (44/47), 89% (42/47), and 98% (46/47). The resistance rate to erythromycin was 74% (35/47). The most common serotype of S. pneumoniae was serotype 19A (10 strains, 21%). The coverage rate of 13-valent conjugate vaccine (PCV13) was 70% (33/47). None of the 13 H. influenzae isolates could be typed. They were highly susceptible to tested β-lactams antibiotics, except ampicillin. Only one H. influenzae isolate could produce β-lactamase, and two isolates were identified as β-lactamase-negative-ampicillin-resistant ones. The sixteen M. catarrhalis isolates were all positive in β-lactamase detection, but sensitive to amoxicillin-clavulanic acid, cephalosporins and meropenem. Conclusions: In Kashi, Xinjiang Uygur Autonmous Region, S. pneumoniae isolates from Uygur children were highly sensitive to parenteral penicillin and other β-lactams antibiotics. H. influenzae isolates from Uygur children were highly susceptible to amoxicillin-clavulanic acid, cephalosporins and ciprofloxacin. All M. catarrhalis isolates from Uygur children could produce β-lactamase, but were sensitive to the enzyme inhibitors and cephalosporins.
目的： 了解喀什维吾尔族儿童鼻咽部肺炎链球菌、流感嗜血杆菌和卡他莫拉菌的血清型分布特征及耐药状况。 方法： 收集2015年10月至2016年2月喀什地区第一人民医院儿科呼吸道感染住院1月龄~<5岁维吾尔族患儿的鼻咽拭子标本，分离肺炎链球菌、流感嗜血杆菌和卡他莫拉菌。采用E-test法和KB纸片扩散法检测分离菌株对常用抗菌药物的敏感性，使用头孢硝噻吩纸片法检测流感嗜血杆菌和卡他莫拉菌分离株是否产β-内酰胺酶，采用荚膜肿胀试验和乳胶凝集试验鉴定肺炎链球菌和流感嗜血杆菌的血清型。 结果： 共分离到肺炎链球菌47株，流感嗜血杆菌13株，卡他莫拉菌16株。47株肺炎链球菌对胃肠外青霉素、阿莫西林-克拉维酸、万古霉素和左氧氟沙星100%敏感，对头孢噻肟、亚胺培南和氯霉素的敏感率高达94%（44/47）、89%（42/47）和98%（46/47），红霉素耐药率为74%（35/47）。肺炎链球菌最常见的血清型为19A型（10株，21%），13价肺炎链球菌结合疫苗覆盖率为70%（33/47）。13株流感嗜血杆菌均不能分型，除外氨苄西林，分离株对其他几种β-内酰胺类抗生素的敏感性均较高，仅1株β-内酰胺酶阳性，发现2株不产酶耐氨苄西林的菌株。16株卡他莫拉菌β-内酰胺酶检测均阳性，但对阿莫西林-克拉维酸、头孢菌素和美罗培南敏感。 结论： 新疆喀什地区维吾尔族儿童肺炎链球菌对胃肠外青霉素等β-内酰胺类敏感率高。流感嗜血杆菌对阿莫西林-克拉维酸、头孢菌素类和环丙沙星敏感率高。卡他莫拉菌对加酶抑制剂、头孢菌素等敏感。.
Keywords: Child; Haemophilus influenzae; Minority groups; Moraxella catarrhalis; Streptococcus pneumoniae.