揭阳地区妊娠期妇女定植无乳链球菌分子流行特征及耐药特点  

Molecular epidemiological characteristics and antibiotic resistance of Streptococcus agalactiae isolated from pregnant women in Jieyang

作　　者：徐勇锋[1] 黄旭东[2] 陈楚兵 黄燕青 黄春明 洪钦明 XU Yong-feng;HUANG Xu-dong;CHEN Chu-bing;HUANG Yan-qing;HUANG Chun-ming;HONG Qin-ming(Department of Clinical Laboratory,Jieyang Hospital of traditional Chinese Medicine,Jieyang 522000,Guangdong,China;不详)

机构地区：[1]揭阳市中医院检验科,广东揭阳522000 [2]揭阳市人民医院检验科,广东揭阳522095 [3]揭阳市妇幼保健计划生育服务中心检验科,广东揭阳522031 [4]揭阳市第三人民医院检验科,广东揭阳522071 [5]揭阳市揭东区人民医院检验科,广东揭阳515500 [6]揭阳市榕城区妇幼保健计划生育服务中心检验科,广东揭阳522000

出　　处：《广东医学》2021年第6期671-676,共6页Guangdong Medical Journal

摘　　要：目的了解揭阳地区妊娠期妇女无乳链球菌的分子流行特征和耐药特征,为其引起感染的防控提供依据。方法收集揭阳地区妊娠35~37周妇女的阴道直肠拭子,对分离到的无乳链球菌进行多位点序列分型(multilocus sequence type,MLST)、分子血清分型、进行药敏试验并检测红霉素和克林霉素耐药基因(ermA、ermB、ermA/E和linB基因)。结果无乳链球菌检出率为9.6%(103/1076),共发现21个序列型(sequence type,ST),来源于8个克隆群(clonal complexes,CCs),CC103占16.6%。共检出5个血清型,以Ⅲ(49.5%)、Ia(24.3%)和Ib(12.6%)为主。红霉素、克林霉素耐药率及多重耐药率分别为:71.8%、60.2%和62.1%。红霉素耐药菌均检出耐药基因,ermA、ermB和mefA/E阳性率为16.2%、83.8%和25.7%;linB基因阳性率为54.8%。共检出cMLSB、iMLSB和M型等3种红霉素耐药表型,分别占73.0%、8.1%和18.9%。结论揭阳地区的定植无乳链球菌具有较高的遗传多样性,其多重耐药率高,红霉素耐药以ermB基因介导的cMLSB型为主,部分克林霉素耐药由linB基因介导。CC103已成为该地区流行的主要CC之一;ST17/血清学Ⅲ型为该地区流行的主要定植菌株之一。Objective To conduct a comprehensive analysis of antibiotic resistance and a molecular-based epidemiological investigation to formulate strategies for the prevention and treatment of Streptococcus agalactiae(S.agalactiae)infections in Jieyang.Methods A total of 1076 non-repeating vaginal-rectal swabs were collected from pregnant women(35-37 weeks of pregnancy).For all the isolates,multilocus sequence typing(MLST),molecular serotyping,antibiotic susceptibilities testing,and erythromycin and clindamycin resistance genes detection were performed.Results In this study,the carriage rate of S.agalactiae in pregnant women in Jieyang was 9.6%(103/1076).All strains were divided into 21 ST types,which were derived from eight clonal complexes,and the CC103 strains accounted for 16.6%.Five serotypes were identified,and the three most common serotype were Serotype Ⅲ(49.5%),Ib(24.3%),and Ia(12.6%).The resistance rates of all strains to erythromycin,clindamycin and multi-drug resistance were 71.8%,60.2%,and 62.1%,respectively.All erythromycin resistant strains harbored resistance genes,and the positive rates of ermA,ermB,and mefA/E were 16.2%,83.8%,and 25.7%,respectively,whereas only 54.8%of clindamycin resistant strains possessed linB gene.Three erythromycin-resistant phenotypes were detected,including cMLSB,iMLSB,and M type,which accounted for 73.0%,8.1%,and 18.9%,respectively.Conclusion The colonized S.agalactiae in Jieyang has relatively high genetic diversity and high multi-drug resistance rate.The main phenotype of erythromycin resistance is cMLSB type,which mediated by ermB gene,and some strains of clindamycin resistance are mediated by the linB genes.CC103 has become one of the most prevalent CC in this area,and ST17/SerotypeⅢis one of the most prevalent colonization ST in this area.

关 键 词：无乳链球菌 多位点序列分型 分子血清分型 耐药基因 

分 类 号：R714.7[医药卫生—妇产科学] R446.1[医药卫生—临床医学]