CAJ | 학술논문

目的了解上海地区化脓性链球菌对红霉素的耐药情况及耐药基因谱的特点.方法 2004年11月至2006年6月经复旦大学附属儿科医院传染病门诊诊断为猩红热的患儿,其咽拭子培养分离获得100株化脓性链球菌.应用PCR及序列分析法检测红霉素耐药基因mefA、ermA、ermB在该批菌株中的分布规律及其与红霉素耐药性的关系.结果上海地区化脓性链球菌的红霉素耐药率为98%,克林霉素耐药率为95%,两者耐药性的一致率为97%.100株菌株中含ermB基因的化脓性链球菌94株,占所有菌株的94%,对红霉索耐药率为100%;含mefA基因的化脓性链球菌16株,占所有菌株的16%,对红霉素耐药率为100%;100株菌株中未发现ermA基因.5株菌株未发现ermB基因及mefA基因,其中2株对红霉素敏感,3株对红霉素耐药.mefA基因单独阳性的菌株仅占1%.结论上海地区化脓性链球菌对红霉奈普遍具有较高耐药率,且与克林霉素存在较严重的交叉耐药.ermB基因是决定上海地区化脓性链球菌对红霉素耐药的重要基因.
목적 료해상해지구화농성련구균대홍매소적내약정황급내약기인보적특점.방법 2004년11월지2006년6월경복단대학부속인과의원전염병문진진단위성홍열적환인,기인식자배양분리획득100주화농성련구균.응용PCR급서렬분석법검측홍매소내약기인mefA、ermA、ermB재해비균주중적분포규률급기여홍매소내약성적관계.결과상해지구화농성련구균적홍매소내약솔위98%,극림매소내약솔위95%,량자내약성적일치솔위97%.100주균주중함ermB기인적화농성련구균94주,점소유균주적94%,대홍매색내약솔위100%;함mefA기인적화농성련구균16주,점소유균주적16%,대홍매소내약솔위100%;100주균주중미발현ermA기인.5주균주미발현ermB기인급mefA기인,기중2주대홍매소민감,3주대홍매소내약.mefA기인단독양성적균주부점1%.결론상해지구화농성련구균대홍매내보편구유교고내약솔,차여극림매소존재교엄중적교차내약.ermB기인시결정상해지구화농성련구균대홍매소내약적중요기인.
Objective To understand the erythromycin resistance rate and the erythromycin resistant gene spectrum in Streptococcus pyogenes strains isolated in Shanghai.Methods The outpatient children who were diagnosed with scarlatinal in the Children's Hospital of Fudan University from November 2004 to June 2006 were enrolled and 100 strains of Streptococcus pyogenes were isolated by pharyngeal swab culture.The distributions ofermA,ermB,mefA genes were determined by polymerase chain reaction(PCR)amplification.The relationship between ermA,ermB,mefA genes and erythromycin resistance were also analyzed.Results The erythromycin and clindamycin resistance rates of Streptococcus pyogenes in Shanghai were 98%and 95%,respectively;the concordance rate of these two drugs was 97%.Among 100 strains of Streptococcus pyogenes,94 strains(94%)contained ermB gene,with 100%of erythromycinresistance rate.Sixteen(16%)contained mefA gene,with 100% of erythromycin resistance rate.ermA was not detected inall the 100 strains.The ermB and mefA genes were not found in 5 strains,among which,2 were susceptible to erythromycin and 3wereresistant to erythromycin.Only 1%of isolates was mefA genesingle positive.Conclusions There is a high erythromycin resistance rate of Streptococcus pyogenes strains isolated inShanghai,and the cross resistance to clindamycin is high.TheermB gene is important erythromycin resistancedeterminants of Streptococcus pyogenes in Shanghai.