临床分离的肺炎链球菌耐药性分析及多位点序列分型  

Antibiotic resistance analysis and multi-locus sequence type of Streptococcus pneumoniae isolated from clinic

作　　者：陈文标[1] 朱焱[2] 黄东红[3] 陈丽霞[1] 陈淑增[1] 邱丹缨 许秀秀[1] 

机构地区：[1]泉州医学高等专科学校基础医学部,泉州362011 [2]福建医科大学附属泉州市第一医院检验科,泉州362000 [3]福建医科大学附属第二医院检验科,泉州362000

出　　处：《中国抗生素杂志》2016年第1期60-63,共4页Chinese Journal of Antibiotics

基　　金：泉州市科技计划项目(No.2012Z73);福建省卫生厅青年课题(No.2012-1-42);2014年中共泉州市委组织部优秀人才培养专项项目

摘　　要：目的了解泉州地区临床分离的肺炎链球菌(Streptococcus pneumoniae,SP)的耐药性特征及多位点序列分型(multilocus sequence type,MLST)。方法针对45株临床分离的SP用E-test法和纸片扩散法检测菌株对14种常用抗菌素的敏感性,以PCR方法检测耐药基因erm B、mef E、mef A及转座子家族int Tn916/Tn1545转座酶基因,采用多位点序列分型(MLST)技术分析菌株序列型(ST)。结果 SP对红霉素、克林霉素、复方磺胺甲噁唑、四环素、青霉素、头孢噻肟、头孢吡肟、美罗培南、阿莫西林、氯霉素、左氧氟沙星的耐药率分别97.8%、93.3%、73.3%、82.2%、26.7%、44.4%、42.1%、26.7%、24.4%、11.1%和4.4%,未见对替考拉宁、利奈唑胺和万古霉素的耐药性;耐药基因erm B、mef E、mef A及转座子家族int Tn916/Tn1545转座酶检出率分别为97.78%、51.11%、44.44%和91.11%;MLST共分出21个ST型,存在一个优势型别ST271,占44.4%(20/45);ST271在mef耐药基因检出率要高于其它散在STs,差异具有统计学意义(P<0.05)。结论本地区分离的SP耐药较为严重,且更多的表现为多重耐药;耐药机制主要表现为erm B编码的23S r RNA甲基化酶致靶位改变以及int Tn916/Tn1545接合性转座子介导的耐药传播;ST271是本地区分离SP的主要ST型,并且以多重耐药为主。Objective To analyze about the antibiotic resistance feature and multi-locussequence type （MLST） of Streptococcus pneumoniae （SP） isolated from clinic between 2012 and 2014. Methods 45 SP strains isolated from clinic were studyed for 14 antibiotic resistance by E-test and Kirby-Bauer. They were investigated about antibiotic resistance genes ermB, merE, mefA and the genetic marker intTn916/Tn1545 transposon gene by PCR. STs were studyed by MLST. Results The resistance rates of 45 SP strains to erythromycin, clindamycin, tetracycline, cotrimoxazole, penicillin, cefotaxime, cefepime, meropenem, amoxicillin, chloramphenicol, ofloxacin were 97.8%, 93.3%, 73.3%, 82.2%, 26.7%, 44.4%, 42.1%, 26.7%, 24.4%, 11.1% and 4.4%, respectively, and the resistance rates susceptibility to teicoplanin, linezolid and vancomycin were 100%. The positive rates of ermB, mefA, merE, int916/Tn1545 were 97.78%, 51.11%, 44.44% and 91.11%, respectively. They were 21 STs by MLST, and ST271 was the main ST, which positive rate was 44.44%. It was statistically significant that multi-drug resistant rate and mef resistance gene between ST271 and other STs （P〈0.05）. Conclusion It is high antibiotic resistance in hospital, and the strains showed multi-drug resistance. Resistance to antibiotic in Streptovoccus pneumoniae generally mediated by methylation of 23S rRNA via ermB methylase, as well as the intTn916/Tn1545. ST271 was the main ST of SP, and they were most antibiotics multi-resistant.

关 键 词：肺炎链球菌 耐药性 多位点序列分型 

分 类 号：R978.1[医药卫生—药品]