学龄前儿童肺炎链球菌耐药性及大环内酯类耐药基因分析  

Analysis of drug-resistance and macrolide-resistant genes of Streptococcus pneumoniae in preschool children

作　　者：赖剑秀 宋相泉 徐菊芳 戴玉柱 段达荣[3] LAI Jian-xiu;SONG Xiang-quan;XU Ju-fang;DAI Yu-zhu;DUAN Da-rong(Department of Clinical Laboratory,The Integrated Traditional Chinese and Western Medicine Hospital in Xihu District,Hangzhou Zhejiang 310000;Department of Clinical Laboratory,The 903rd Hospital of PLA,Hangzhou Zhejiang 310013;Department of Clinical Laboratory,The First People′s Hospital of Taizhou,Taizhou Zhejiang 318020,China)

机构地区：[1]浙江省杭州市西湖区中西医结合医院检验科,310000 [2]解放军第九〇三医院检验科,浙江杭州310013 [3]浙江省台州市第一人民医院检验科,318020

出　　处：《蚌埠医学院学报》2023年第11期1577-1580,共4页Journal of Bengbu Medical College

摘　　要：目的:了解学龄前儿童肺炎链球菌(Streptococcus pneumoniae,Sp)的耐药性及大环内酯类耐药基因分布。方法:选取60株Sp,采用E-test法检测菌株对青霉素、阿莫西林、头孢噻肟、头孢曲松的最低抑菌浓度;纸片扩散法检测Sp对红霉素、克林霉素、复方新诺明、四环素、氯霉素、左氧氟沙星、万古霉素、利奈唑胺的药物敏感性;PCR检测大环内酯类耐药基因ermB、mefA和mefE的检出率。患儿按年龄分为0~12个月组、13~36个月组和37~60个月组,比较各组抗菌药物不敏感率和耐药基因检出率。结果:药敏试验结果显示,60株Sp对红霉素、四环素和复方新诺明的耐药率较高,分别为95.00%,93.30%,61.07%;Sp对万古霉素、厄他培南、利耐唑胺和泰利霉素均敏感,敏感率为100.00%。0~12个月组儿童对头孢噻肟、头孢曲松、青霉素G、阿莫西林、红霉素、美洛培南不敏感率均高于13~36个月组和37~60个月组,其中3组头孢噻肟、头孢曲松不敏感率差异有统计学意义(P<0.05),36~60个月组儿童对复方新诺明、氧氟沙星、四环素不敏感率最高。PCR结果显示,大环内酯类耐药基因ermB检出率最高(98.33%),mefA和ermB+mefA测出率均为78.33%,mefE和ermB+mefE检出率均为60.00%,ermB+mefA+mefE检出率最低(46.67%)。mefE和ermB+mefE在0~12个月组、13~36个月组、37~60个月组检出率逐渐降低(P<0.05)。结论:学龄前儿童Sp对大环内酯类耐药率较高,ermB耐药基因为Sp对大环内酯类抗生素耐药的主要基因型。Objective:To understand the drug resistance of Streptococcus pneumoniae(Sp)and the distribution of macrolide-resistant genes in preschool children.Methods:Sixty Sp strains were selected,and the minimum inhibitory concentrations of penicillin,amoxicillin,cefotaxime and ceftriaxone were detected by E-test method;the susceptibility of Sp to erythromycin,clindamycin,cotrimoxazole,tetracycline,chloramphenicol,levofloxacin,vancomycin and linezolid was detected by disk diffusion method;the detection rate of macrolide-resistant genes ermB,mefA and mefE was determined by PCR.The children were divided into 0 to 12-month group,13 to 36 month group and 37 to 60-month group according to their age.The antimicrobial insensitivity rate and the detection rate of drug resistance genes in the three groups were compared.Results:The results of drug sensitivity test displayed that the 60 strains of Sp showed high drug resistance rate to erythromycin,tetracycline and cotrimoxazole,and the resistance rates were 95.0%,93.3%and 61.7%,respectively;Sp was sensitive to vancomycin,ertapenem,linezolid and telithromycin,and the sensitivity rate was 100.0%.The insensitivity rates of children to cefotaxime,ceftriaxone,penicillin G,amoxicillin,erythromycin and meropenem in the 0 to 12-month group were higher than those in the 12 to 36-month group and 36 to 60-month group,the difference of insensitivity rates of cefotaxime,ceftriaxone among the three groups was statistically significant(P<0.05),and the insensitivity rates of children to cotrimoxazole,ofloxacin and tetracycline in the 36 to 60-month group were the highest.The PCR results showed that the detection rate of macrolide-resistant gene ermB was the highest(98.33%),which was 78.33%for mefA and ermB+mefA,60.00%for mefE and ermB+mefE,and 46.67%for ermB+mefA+mefE.The detection rates of mefE and ermB+mefE gradually decreased in the 0 to 12-month group,13 to 36-month group and 37 to 60-month group(P<0.05).Conclusions:The resistance rate of Sp to macrolide in preschool children is high,and the re

关 键 词：肺炎链球菌 耐药率 耐药基因 学龄前儿童 

分 类 号：R378.1[医药卫生—病原生物学]