肺炎链球菌对大环内酯类抗菌药物耐药机制的研究  

Antimicrobial Resistance of Streptococcus pneumoniae and Mechanisms of Resistance to Macrolides

作　　者：吴金英[1] 李少君[1] 徐新波[1] 韩颖杰[1] 杜江东[1] 杨少虹[1] 苏兆兰[1] 

机构地区：[1]青岛大学医学院附属烟台毓璜顶医院检验中心,山东烟台264000

出　　处：《中华医院感染学杂志》2008年第12期1681-1683,共3页Chinese Journal of Nosocomiology

基　　金：山东省烟台市科技发展计划资助项目(2005126)

摘　　要：目的调查烟台地区肺炎链球菌对抗菌药物的敏感性,研究烟台地区肺炎链球菌对大环内酯类抗菌药物耐药机制。方法收集社区和临床分离的肺炎链球菌,根据美国临床实验室标准化研究所/美国临床实验室标准化委员会(CLSI/NCCLS)的推荐,用K-B法、Etest法检测肺炎链球菌对青霉素等11种抗菌药物的耐药性及对大环内酯类抗菌药物的耐药表型;用聚合酶链反应(PCR)扩增耐药基因ermB和mefE基因。结果42株肺炎链球菌中25株对青霉素低度耐药(65.0%),无对青霉素高度耐药株;肺炎链球菌对大环内酯类和克林霉素表现出极高的耐药率,对红霉素和克林霉素耐药率为98.0%和93.0%;42株肺炎链球菌中40株检测到ermB基因、1株检测到mefE基因,其中9株菌同时检测到ermB和mefE基因。结论烟台地区对青霉素不敏感肺炎链球菌检出率高;对红霉素和克林霉素近乎全部耐药,ermB基因介导的靶位改变是烟台地区肺炎链球菌对大环内酯类抗菌药物的主要耐药机制。OBJECTIVE To investigate the antimicrobial susceptibility of Streptococcus pneurnoniae isolated in Yantai and their mechanisms of resistance to macrolides. METHODS Antimicrobial susceptibility of S. pneurnoniae was determined by agar dilution method. Phenotypes of macrolide-resistant S. pneumoniae were determined using double disk test with erythromycin and clindamycin disks, ermB And mefE genes were amplified by PCR. RESULTS Among 42 strains of S. pneumoniae, 65. 0% were intermediate to and no strain was resistant to penicillin. The resistance rates to erytbromycin and clindamycin were 93.0%, respectively. Of 41 erythromycin resistantstrains, 93.0% were constitutive resistant, ermB Was detected in 40 strains and mefE in 1 strain, both ermB and mefE genes were found in 9 strains. CONCLUSIONS The resistance rate of S. pneumoniae to penicillin is high in Yantai area, the resistance rates to erythromycin and clindamycin are very high. Target modification by ermB methylase is the predominant mechanism in macrolide-resistant S. pneurnoniae in Yantai.

关 键 词：肺炎链球菌 大环内酯类 耐药机制 ERMB基因 mefE基因 

分 类 号：R378.12[医药卫生—病原生物学]