MSSA携带耐药基因erm与泰利霉素体外敏感性的关系  

Relationship between in-vitro sensitivity of telithromycin and antibiotic resistance gene erm from MSSA L

作　　者：刘欢欢 陈炳潮 黄震 IU Huan-huan;CHEN Bing-chao;HUANG Zhen(Department of Pharmacy,the TCM hospital of Baoan District,Shenzhen 518101,China)

机构地区：[1]深圳市宝安区中医院药学部,广东深圳518100 [2]深圳市宝安区人民医院肺科门诊,广东深圳518101

出　　处：《中国处方药》2023年第12期1-5,共5页Journal of China Prescription Drug

摘　　要：目的调查临床分离的甲氧西林敏感金黄色葡萄球菌(MSSA)中红霉素耐药相关基因erm的分布情况,并分析耐药基因erm对新型大环内酯类药物泰利霉素体外敏感性的影响。方法实验用菌株为华中科技大学协和深圳医院鉴定并保存的2011~2015年非重复的各科室各标本来源的MSSA 121株,通过微量肉汤稀释法及K-B纸片法测定菌株对泰利霉素和10种抗菌药的MIC值,并进一步对所有红霉素耐药的菌株进一步行D-试验以区分红霉素耐药菌株的MLSB耐药表型,之后采用PCR法检测erm基因中三种最常见亚型ermA、ermB、ermC的分布情况。结果MSSA对泰利霉素中介1株,耐药51株,耐药率达43.0%,对红霉素耐药率则高达61.2%。所有MSSA均对替考拉宁、利奈唑胺、万古霉素、阿莫西林/克拉维酸及苯唑西林敏感;121株MSSA中有74株(61.2%)携带erm基因,其中25株(20.7%)携带ermB,且均为cMLS_(B)表型;10株(8.3%)携带ermA,且均为iMLS_(B)表型;40株(33.1%)携带ermC,其中cMLS_(B)表型9株,iMLS_(B)表型31株;仅有1株MSSA同时携带ermB及ermC且为cMLS_(B)表型,该菌株对泰利霉素耐药。所有erm基因阳性的MSSA对泰利霉素MIC值较阴性组显著增高。结论该院MSSA对泰利霉素耐药率较高,但泰利霉素较经典大环内酯类药物红霉素抗菌效果已有显著提升,且其体外敏感性与MSSA中是否携带erm基因密切相关,erm基因阳性且为cMLS_(B)表型的MSSA更容易引起泰利霉素耐药发生。Objective To investigate the distribution of antibiotic resistance gene erm,which related to erythromycin resistance,in clinically isolated methicillin-sensitive staphylococcus aureus(MSSA)and to analyze the effect of erm on the in-vitro sensitivity to the novel macrolides telithromycin.Methods 121 non-duplicated MSSA strains identified from different departments and specimens and preserved in Huazhong University of Science and Technology Union Shenzhen Hospital from 2011 to 2015,were adopted in this experiment.The MIC values of the strains to telithromycin and 10 antimicrobial drugs were determined by broth microdilution method and K-B disk diffusion method.D-tests were performed to distinguish the MLSB resistant phenotype of all the erythromycin resistant strains,and the distribution of ermA,ermB,and ermC,the most common subtypes of the erm gene,were detected by PCR.Results 51 strains of MSSA was resistant and 1 strain intermediate resistant to telithromycin,with a antibiotic resistance rate of 43.0%,and an erythromycin resistance rate of 61.2%.All MSSA were sensitive to the commonly used drugs including amoxicillin/clavulanic acid,oxacillin,vancomycin,linezolid,and teicoplanin;among 121 strains of MSSA,74(61.2%)carried erm gene,and 25(20.7%)strains with cMLS_(B) phenotypes carried ermB;10(8.3%)strains carried ermA were all iMLS_(B) phenotypes;40(33.1%)strains carried ermC,of which 9 strains were cMLS_(B) phenotypes and the other 31 strains were iMLS_(B) phenotype.Only one strain of MSSA carried both ermB and ermC and showed cMLS_(B) phenotype,which was resistant to telithromycin.The MIC of telithromycin to the MSSA of erm gene positive were significantly higher than erm negative group.Conclusion MSSA has a high antibiotic resistance rate to telithromycin in this hospital,but it's more potent than the classic macrolides erythromycin and the in-vitro sensitivity of telithromycin is closely related to whether the erm gene is carried in MSSA.The MSSA with erm gene positive and cMLS_(B) phenotype is more likely to

关 键 词：甲氧西林敏感金黄色葡萄球菌 酮内酯 耐药 泰利霉素 ERM 

分 类 号：R446.5[医药卫生—诊断学]