中国人兽共患病学报
中國人獸共患病學報
중국인수공환병학보
CHINESE JOURNAL OF ZOONOSES
2010年
3期
255-258,262
,共5页
潘方平%吴璐怡%叶云飞%孙爱华
潘方平%吳璐怡%葉雲飛%孫愛華
반방평%오로이%협운비%손애화
肺炎链球菌%耐药性%ermB基因%mefE基因
肺炎鏈毬菌%耐藥性%ermB基因%mefE基因
폐염련구균%내약성%ermB기인%mefE기인
Streptococcus pneumoniae%drug resistance%ermB gene%mefE gene
目的 了解浙江地区肺炎链球菌临床菌株对临床常用抗生素耐药性以及肺炎链球菌对大环内酯类抗生素耐药机制.方法 从浙江省不同地区病人临床标本中分离并鉴定肺炎链球菌138株.采用K-B纸片法和E-test检测上述肺炎链球菌临床菌株对9种抗生素的敏感性.采用PCR检测上述菌株中与大环内酯类抗生素耐药性密切相关的ermB和mefE基因携带情况.分析ermB和mefE基因携带、分布状况与红霉素耐药性关系.结果 138株肺炎链球菌临床菌株中,对红霉素耐药率高达93.5%(129/138),对头孢噻肟、头孢呋辛、阿莫西林和左氧氟沙星的耐药率较低(2.9%～4.3%).上述菌株ermB基因检测阳性率(91.3%,126/138)明显高于mefE基因(33.3%,46/138)(P<0.05),其中27.5%菌株(38/138)同时携带.不携带ermB和mefE基因菌株均对红霉素敏感,仅携带mefE基因菌株对红霉素耐药率(62.5%)明显低于同时携带两种基因菌株耐药率(100%)及仅携带ermB基因菌株耐药率(97.7%)(P<0.05).结论 红霉素已不适合作为治疗肺炎链球菌感染性疾病的药物.ermB基因是肺炎链球菌临床菌株携带的红霉素耐药相关优势基因.ermB基因可使肺炎链球菌产生较mefE基因更强的红霉素耐药性.
目的 瞭解浙江地區肺炎鏈毬菌臨床菌株對臨床常用抗生素耐藥性以及肺炎鏈毬菌對大環內酯類抗生素耐藥機製.方法 從浙江省不同地區病人臨床標本中分離併鑒定肺炎鏈毬菌138株.採用K-B紙片法和E-test檢測上述肺炎鏈毬菌臨床菌株對9種抗生素的敏感性.採用PCR檢測上述菌株中與大環內酯類抗生素耐藥性密切相關的ermB和mefE基因攜帶情況.分析ermB和mefE基因攜帶、分佈狀況與紅黴素耐藥性關繫.結果 138株肺炎鏈毬菌臨床菌株中,對紅黴素耐藥率高達93.5%(129/138),對頭孢噻肟、頭孢呋辛、阿莫西林和左氧氟沙星的耐藥率較低(2.9%～4.3%).上述菌株ermB基因檢測暘性率(91.3%,126/138)明顯高于mefE基因(33.3%,46/138)(P<0.05),其中27.5%菌株(38/138)同時攜帶.不攜帶ermB和mefE基因菌株均對紅黴素敏感,僅攜帶mefE基因菌株對紅黴素耐藥率(62.5%)明顯低于同時攜帶兩種基因菌株耐藥率(100%)及僅攜帶ermB基因菌株耐藥率(97.7%)(P<0.05).結論 紅黴素已不適閤作為治療肺炎鏈毬菌感染性疾病的藥物.ermB基因是肺炎鏈毬菌臨床菌株攜帶的紅黴素耐藥相關優勢基因.ermB基因可使肺炎鏈毬菌產生較mefE基因更彊的紅黴素耐藥性.
목적 료해절강지구폐염련구균림상균주대림상상용항생소내약성이급폐염련구균대대배내지류항생소내약궤제.방법 종절강성불동지구병인림상표본중분리병감정폐염련구균138주.채용K-B지편법화E-test검측상술폐염련구균림상균주대9충항생소적민감성.채용PCR검측상술균주중여대배내지류항생소내약성밀절상관적ermB화mefE기인휴대정황.분석ermB화mefE기인휴대、분포상황여홍매소내약성관계.결과 138주폐염련구균림상균주중,대홍매소내약솔고체93.5%(129/138),대두포새우、두포부신、아막서림화좌양불사성적내약솔교저(2.9%～4.3%).상술균주ermB기인검측양성솔(91.3%,126/138)명현고우mefE기인(33.3%,46/138)(P<0.05),기중27.5%균주(38/138)동시휴대.불휴대ermB화mefE기인균주균대홍매소민감,부휴대mefE기인균주대홍매소내약솔(62.5%)명현저우동시휴대량충기인균주내약솔(100%)급부휴대ermB기인균주내약솔(97.7%)(P<0.05).결론 홍매소이불괄합작위치료폐염련구균감염성질병적약물.ermB기인시폐염련구균림상균주휴대적홍매소내약상관우세기인.ermB기인가사폐염련구균산생교mefE기인경강적홍매소내약성.
In order to understand the resistance against common antibiotics in clinic and macrolide antibiotic-resistant mechanism of Streptococcus pneumoniae (S.pneumoniae) isolates in Zhejiang area,both K-B slip method and E-test were applied to determine the sensitivity of 138 S.pneumoniae isolates to nine antibiotics,and the ermB and mefE genes in those isolates which associated with macrolide antibiotics-resistance closely were detected by PCR.Subsequently,correlation among ermB and mefE genes and the erythromycin resistance were analyzed.For these 138 S.pneumoniae isolates,93.5% (129/138) of the strains were resistant to erythromycin,but only 2.9%～4.3% strains were resistant to cefotaxim,cefuroxime,amoxicillin and levofloxacin.The positive rate of ermB gene in the isolates (91.3%,126/138) was significantly higher than that of mefE gene (33.3%,46/138) (P<0.05).Both of these two genes existed in 27.5 % (38/138) of the strains and all of the strains without ermB and mefE genes were sensitive to erythromycin.The erythromycin resistance rate (62.5%) of mefE gene positive strains was remarkably lower than that of the mefE&ermB gene positive strains (100%) and the ermB gene positive strains (97.7%) (P<0.05).All the data mentioned above demonstrated that erythromycin is not an appropriate antibiotic to treat the infectious diseases caused by S.pneumoniae.Moreover,ermB is the predominant erythromycin resistance gene in S.pneumoniae isolates and ermB gene could inspire stronger erythromycin resistance than mefE gene.
