克林霉素诱导耐药B族链球菌同源性分析及耐药基因研究  

Homology and drug resistance gene analysis of Group B Streptococcus resistance induced by clindamycin

作　　者：高晶 汪雅萍[2] 蒋南燕 彭怡倩 刘璐 仉英 陈艺升 应春妹 

机构地区：[1]复旦大学附属妇产科医院检验科,上海200011 [2]上海交通大学医学院附属仁济医院

出　　处：《中华检验医学杂志》2018年第1期24-28,共5页Chinese Journal of Laboratory Medicine

基　　金：上海青年临床医技人才（临床检验专业）培养资助计划资助项目（沪医卫基[2016]04号）

摘　　要：目的研究克林霉素诱导耐药B族链球菌（GBS）的同源性和耐药基因，为临床预防和治疗克林霉素诱导耐药GBS感染提供依据。方法收集2014年1月至2015年12月复旦大学附属妇产科医院GBS 921株，使用VITEK2－compact全自动细菌药敏仪检测这些菌株对7种抗菌药物的敏感性，挑选红霉素耐药、克林霉素敏感或中介的D－抑菌圈试验阳性菌株63株，采用多位点序列分型方法确定菌株序列型，使用PCR方法检测红霉素耐药基因mefA和ermB，分析耐药性、多位点序列分型和耐药基因的相关性。结果921株GBS中红霉素耐药率53.4%（492/921株），克林霉素耐药率50.2%（462/921株），左氧氟沙星耐药率34.7%（320/921株），呋喃妥因耐药率7.5%（69/921株）；63株克林霉素诱导耐药GBS菌株左氧氟沙星耐药率27.0%（17/63株），未检出青霉素、万古霉素和呋喃妥因耐药的菌株；克林霉素诱导耐药GBS菌株包含12种ST型，以ST12（31.7%）（20/63株）和ST19（25.4%）（16/63株）最常见，发现一个新的ST型：ST1072；ST19左氧氟沙星耐药率（75.0%）（12/16株）较其他ST型更高；63株GBS中mefA、ermB检出率分别为27.0%（17/63株）和41.3%（26/63株）。结论本研究检出克林霉素诱导耐药的GBS具有遗传多样性，不同ST型耐药性及相关耐药基因的检出亦有显著差异。ObjectivesTo investigate the homology and drug resistance gene of Group B Streptococcus （GBS） Resistance induced by Clindamycin and provide basic data for clinical prevention and treatment of GBS Resistance infection induced by Clindamycin.Methods921 strains of GBS were isolated at Obstetrics ＆ Gynecology Hospital of Fudan University from January, 2014 to December, 2015. VITEK2-compact automatic bacterial susceptibility instrument was used to test their sensitivity to 7 antibacterial drugs. 63 positive strains were chosen through D-inhibition zone trial which were drug resistant to Erythromycin and susceptible or intermediary to Clindamycin. The strain′s sequence type was identified by the method of multilocus sequence typing （MLST typing）. The drug resistance genes mefA ＆ ermB to Erythromycin were detected by using PCR method. The analysis was carried out to reveal the relevance to drug resistance, multilocus sequence typing and drug resistance gene.ResultsAmong 921 strains of GBS, the drug resistance rate was respectively 53.4% （492/921 strains） to Erythromycin, 50.2% （462/921 strains） to Clindamycin, 34.7% （320/921 strains） to Levofloxacin and 7.5% （69/921 strains） to Nitrofurantoin. The drug resistance rate of Levofloxacin for 63 GBS strains was 27.0% （17/63 strains） and no drug resistant strain was found to Penicillin, Vancomycin ＆ Nitrofurantoin. 12 different ST types were involved in total, including a new ST type： ST1072. The most common ones were ST12 （30.1%） （20/63 strains） ＆ ST19 （25.4%） （16/63 strains）. The drug resistance rate of Levofloxacin with ST19 （75.0%） （12/16 strains） was much higher than that of other ST types. The relevance ratio of mefA and ermB among 63 GBS strains was respectively 27.0% （17/63 strains） and 41.3% （26/63 strains）.ConclusionsThe genetic diversity existed in Group B Streptococcus resistance induced by Clindamycin detected in this study. There was significant difference on drug resistance and relevant dru

关 键 词：B族链球菌 多位点序列分型 耐药基因 

分 类 号：R446.5[医药卫生—诊断学]