肺炎链球菌耐药性与分子流行病学研究  

Resistance and Molecular Epidemiology of Streptococcus pneumoniae

作　　者：胡晓彦[1] 桂炳东[1] 王伶[1] 胡龙华[1] 贾坤如[1] 叶倩[1] 

机构地区：[1]南昌大学第二附属医院检验科,江西南昌330006

出　　处：《中华医院感染学杂志》2009年第4期380-383,共4页Chinese Journal of Nosocomiology

基　　金：江西省科技厅重点项目(2007)

摘　　要：目的调查南昌地区肺炎链球菌(SPN)的耐药性及分子流行病学特征。方法用K-B纸片扩散法和E试验检测肺炎链球菌对10种抗菌药物的耐药状况,并采用BOX-PCR对29株临床分离SPN进行基因分析。结果SPN对红霉素、克林霉素和四环素的耐药率很高(85.7%、79.8%、88.1%);对青霉素不敏感株为48株(57.1%);左氧氟沙星、阿莫西林/克拉维酸对该组细菌有较好的体外活性,敏感率分别为83.3%和88.1%;所有菌株对万古霉素敏感;29株肺炎链球菌共分为14个型,19个亚型,最多见的为A亚型(4株)。结论南昌地区肺炎链球菌对青霉素耐药率较高,BOX-PCR技术对SPN基因分型条带清晰、分辨率高、重复性好,能够快速、可靠地检测SPN及菌株间亲缘关系,适合进行流行病学调查。OBJECTIVE To investigate the drug resistance of clinical isolates of Streptococcus pneumoniae and molecular epidemiology with BOX-PCR in Nanchang. METHODS Antibiotic susceptibility was determined by the Etest methods or K-B disk diffusion test. Twenty-nine Penicillin-resistant S. pneumoniae（PRSP） clinical isolates were molecularly typed by BOX-PCR to detect the clonal relationship of them. RESULTS 85.7 % were resistant to erythromycin, 57. 1% were PRSP. The resistant rates to tetracycline, clindamycin, trimethoprim-sulfamethoxazole and chloramphenicol were 88.1% , 79.8% , 60.7% , and 28.6%. Amoxicillin/clavulanic acid, levofloxacin and ceftriaxone retained activity against most of the isolates. All of strains were susceptible to vancomycin. Twenty-nine S. pneumoniae strains were divided into 14 distinct types, and 19 subtypes with subtype A （n= 4） as the predominant type. CONCLUSIONS The resistance rate of S. pneumoniae to penicillin is very high, BOX-PCR typing demonstrats a high discriminatory potential and easy to be accurately analyzed.

关 键 词：肺炎链球菌 耐药性 BOX—PCR 流行病学 

分 类 号：R378[医药卫生—病原生物学]