云南地区耐大环内酯-林可酰胺类痤疮丙酸杆菌的23S rRNA点突变和携带erm基因分析  

23S rRNA Point Mutation and erm Gene of Macrolide-Lincosamide Resistant Cutibacterium Acnes in Yunnan Area

作　　者：史春雨 唐万娟 杜艳[2] 王皓磊 李玲双 杨晓艳 任玉吉 孙东杰[1] SHI Chunyu;TANG Wanjuan;DU Yan;WANG Haolei;LI Lingshuang;YANG Xiaoyan;REN Yuji;SUN Dongjie(Department of Dermatology,First Affiliated Hospital of Kunming Medical University,Kunming 650032,China;Department of Laboratory Medicine,First Affiliated Hospital of Kunming Medical University,Kunming 650032,China)

机构地区：[1]昆明医科大学第一附属医院皮肤科,云南昆明650032 [2]昆明医科大学第一附属医院检验科,云南昆明650032

出　　处：《中国皮肤性病学杂志》2024年第6期608-611,619,共5页The Chinese Journal of Dermatovenereology

基　　金：国家自然科学基金地区项目(82260618);云南省皮肤免疫性疾病临床医学中心(ZX2019-03-02);云南省“兴滇英才支持计划项目经费”(XDYC-MY-2022-0067)。

摘　　要：目的探讨云南地区痤疮患者皮损分离的耐大环内酯-林可酰胺(Macrolide Lincosamide,ML)类抗生素的痤疮丙酸杆菌(Propionibacterium acnes,P.acnes)23S rRNA点突变及erm(X)基因携带情况。方法招募寻常痤疮患者149例,皮损分离、培养、鉴定P.acnes后用E-test法测定MIC值,以标准株ATCC 6919作为对照,PCR法扩增部分敏感株及全部耐ML株23S rRNA、erm(X)、Tn5432、IS1249,对23S rRNA测序。结果共培养出139株P.acnes临床分离株,其中53株对ML类抗生素高度耐药(MIC均>256μg/mL),仅2株对克林霉素耐药,6株对红霉素耐药,78株敏感;在53株ML类耐药株中,检出与既往报道相同的耐药相关点突变,包括2株在相当于大肠杆菌(E.coli)23S rRNA 2058位点A→G突变,4株在2059位点A→G突变;检出既往未报道的突变,包括3株在2058位点A→T突变,25株在250位点T→C突变,6株在855位点G→A突变,不排除与耐药相关;在53株ML类耐药株中均检出erm(X)基因。结论云南地区痤疮患者皮损分离的耐ML类抗生素的P.acnes携带已知相当于E.coli 23S rRNA 2058、2059 A→G点突变并携带erm(X)基因,部分未报道突变是否与耐药有关有待研究;本地区痤疮患者的P.acnes耐ML类抗生素耐药基因监测情况需要动态、持续进行。Objective To investigate the 23S rRNA point mutation and erm(X)gene carriage of Macrolide Lincosamide(ML)antibiotic-resistant Propionibacterium acnes(P.acnes)isolated from skin lesions of acne patients in Yunnan.Methods One hundred and forty-nine patients with common acne were recruited.After skin lesions were isolated,cultured,and identified,P.acnes was used to determine MIC values by the E-test method,and the standard strain ATCC 6919 was used as a control.23S rRNA,erm(X),Tn5432,and IS1249 were amplified by PCR in some sensitive strains and in all ML-resistant strains,and 23S rRNA was sequenced.Results A total of 139 clinical isolates of P.acnes were cultured,of which 53 were highly resistant to ML antibiotics(all with MIC>256μg/mL),2 were resistant to clindamycin only,6 were resistant to erythromycin only,and 78 were sensitive;among the 53 ML-resistant strains,the same resistance-associated point mutations were detected as those reported in the previous reports,including 2 strains with resistance-related point mutations at the equivalent of E.coli 23S among the 53 ML-resistant strains,the same resistance-related point mutations as those previously reported were detected,including two A→G mutations at the equivalent of E.coli 23S rRNA at position 2058 and four A→G mutations at position 2059;previously unreported mutations were detected,including three A→T mutations at position 2058,25 T→C mutations at position 250,and six G→A mutations at position 855,which could not be ruled out as being related to resistance;the erm(X)gene was detected in all of the 53 ML-resistant strains.Conclusion ML-resistant P.acnes isolated from skin lesions of acne patients in Yunnan region carries mutations known to be equivalent to E.coli 23S rRNA 2058,2059 A→G point mutations and erm(X)genes,and it remains to be investigated whether some of the unreported mutations are related to drug resistance.Monitoring of ML-resistant antibiotic-resistant genes in acne patients in the region needs to be conducted dynamically and con

关 键 词：痤疮丙酸杆菌 抗生素 耐药机制 基因测序 PCR 

分 类 号：R758.733[医药卫生—皮肤病学与性病学]