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| Study on Drug Resistance Distribution and Genotyping of Streptococcus Pneumoniae in Children with Influenza A in A Tertiary Hospital |
| ZHU Jun, KONG Yan, SHI Xiaodi, et al |
| Gaochun People's Hospital of Nanjing City in Jiangsu, Jiangsu Nanjing 211300, China |
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Abstract Objective: To investigate the distribution and genotyping of Streptococcus pneumoniae (SPN) resistance in children with influenza A in a class a hospital of grade III. Methods: 476 children with influenza A treated in Gaochun People's Hospital of Nanjing City were selected from January 2016 to January 2019, samples of pharyngeal swab or nasal swab were collected, after identification of Streptococcus pneumoniae by OPTOXIN test and automatic microbiological identification instrument, the agar dilution method was used to confirm the susceptibility of bacteria by automatic bacterial identification/susceptibility system, and polymerase chain reaction (PCR) was used to detect the drug resistance genotypes of Streptococcus pneumoniae. Results: 36 strains of Streptococcus pneumoniae (7.56%) were isolated from throat swabs or nasal swabs of 476 children with influenza A. Among them, 35 strains (97.22%) were resistant to erythromycin, 31 strains (86.11%) were resistant to clindamycin, 36 strains (100.00%) were resistant to penicillin, 3 strains (8.33%) were resistant to vancomycin, 30 strains (83.33%) were resistant to azithromycin, 32 strains (88.11%) were resistant to ceftazidime. 89%, 1 strain (2.78%) was resistant to meropenem, 36 strains (100.00%) were resistant to tetracycline, 11 strains (30.56%) were resistant to linezolid and 36 strains (47.22%) were resistant to moxifloxacin. 36 strains of Streptococcus pneumoniae contained 32 strains of pbp2B resistance gene (88.89%), 17 strains of ermA resistance gene (47.22%), 21 strains of mefB resistance gene (58.33%) and 30 strains of tetM resistance gene (83.33%). The mutations of pbp2B, ermA, mefB and tetM genes were highly consistent with their drug resistance phenotypes, the detection rates of pbp2B gene in Streptococcus pneumoniae resistant to penicillin and ceftazidime were 88.89% and 100.00% respectively, the detection rates of either or both of ermA and mefB genes exist simultaneously in erythromycin-resistant and azithromycin-resistant Streptococcus pneumoniae were 97.14% and 93.33%, respectively, and the detection rate of tetM gene in tetracycline-resistant Streptococcus pneumoniae was 83.33%. Conclusion: Streptococcus pneumoniae is highly resistant to penicillin, erythromycin, tetracycline and other antibiotics. Its resistance is related to the expression of related resistance genes (pbp2B, ermA, mefB, tetM). Etiological detection should be strengthened to facilitate rational selection of antibiotics.
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2020, Vol. 26 
