儿童肺炎链球菌红霉素、四环素相关耐药基因的研究  

Relationship of erythromycin and tetacycline resistance gene and resistance phenotype in sreptococcus pneumoniae

作　　者：杨锦红[1] 周义正[1] 刘立雪[1] 李向阳[1] 

机构地区：[1]温州医学院附属育英儿童医院,浙江温州325027

出　　处：《中国卫生检验杂志》2008年第5期866-869,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的：了解儿童肺炎链球菌（Streptococcus pneumoniae,SP）临床分离株红霉素、四环素耐药基因的流行状况及和耐药表型的关系。方法：对2005年1月-12月从温州附属育英儿童医院住院儿童分离到的47株肺炎链球菌进行了红霉素、四环素药敏试验,并用PCR法检测与红霉素耐药相关的红霉素核糖体甲基化酶基因（ermB）、主动外排转运基因（mefA）,与四环素耐药相关的tetM基因。结果：47株肺炎链球菌红霉素敏感3株、耐药44株;四环素敏感5株、耐药42株。3株红霉素敏感的肺炎链球菌均未检出ermB基因和mefA基因;44株红霉素耐药肺炎链球菌ermB基因和mefA基因的PCR检出率分别为81.8%和29.5%。共有39株肺炎链球菌检出ermB基因或/和mefA基因,其中单独携带ermB基因的耐药表型为29株,占74.4%;单独携带mefA基因的耐药表型2株,占5.1%;同时携带ermB基因和mefA基因的耐药表型8株,占20.5%。47株肺炎链球菌tetM基因的检出率为87.2%,其中四环素耐药组的检出率是95.2%,敏感组为25%。结论：ermB基因和mefA基因同时表达或单独表达均可导致红霉素耐药,ermB基因表达是儿童肺炎链球菌对红霉素耐药的主要原因,mefA基因表达是造成对红霉素耐药的次要原因。tetM基因是造成儿童肺炎链球菌四环素耐药的主要原因。红霉素和四环素已不是治疗肺炎链球菌的有效药物。肺炎链球菌四环素耐药尚存在其他的耐药机制。Objective：To investigate the prevalence of erythromycin and tetacycline resistance gene and the relationship of drug resistance gene and resistance phenotype in sreptococcus pneumoniae isolated from children patients.Methods：A total of 47 strains of S.pneumoniae were isolated from children patients from Jan 2005 to Dec 2005 at children of Yuying Pediatric Hospital Of Wenzhou Medical College.Erythomycin and tetacycline sensitivity test was done by using MIC method.The erythromycin resistance gene（ermB/mefA） and tetacycline resistance gene（tetM） were detected by PCR.Results：In all 47 strains,44 strains were erythromycin resistant and 3 strains were erythromycin sensitive,42 strains were tetacycline resistant and 5 strains were tetacycline sensitive.The total detection rate of erythromycin resistance gene ermB and mefA were 81.8% and 29.5% respectively in 44 erythromycin-resistance S.pneumoniaes.There were neither gene ermB nor gene mefA in 3 erythromycin-sensitiveness S.pneumoniaes.The erythromycin resistance gene ermB or mefA were detected in 39 strains,the gene ermB was lonely in 29（74.4%） strains, the gene mefA was lonely in 2（5.1%） strains,there were both gene ermB and gene mefA in 8（20.5%） strains.The total detection rate of tetacycline resistance gene is 87.2% in 47 strains,The detection rate of tetacycline resistance gene is 95.2% in tetacycline resistance strains and 25% in tetacycline sensitive strains.Conclusion：The erythromycin resistance of S.pneumoniae can be caused mainly by gene expression of ermB or mefA,But the gene mefA seems to be less important than gene ermB.The tetacycline resistance of S.pneumoniae is caused mainly by tetacycline resistance gene tetM.Obviously the erythromycin and tetacycline aren′t useful in treating S.pneumoniae infection.There may be other mechanism of tetacycline resistance in S.pneumoniae.

关 键 词：肺炎链球菌 ERMB基因 mefA基因 TETM基因 

分 类 号：R563.1[医药卫生—呼吸系统]