呼吸道标本来源的无乳链球菌分子特征和药物敏感性分析  

Molecular characteristics and drug susceptibility analysis of Streptococcus agalactiae from respiratory specimen sources

作　　者：韩肖 龚心怡 苗贝贝 邢欢 刘泽梁 高鹏芳 李跃龙 李嘉琛 汤雅婷 戈艳蕾 董爱英 李娟[2] Han Xiao;Gong Xinyi;Miao Beibei;Xing Huan;Liu Zeliang;Gao Pengfang;Li Yuelong;Li Jiachen;Tang Yating;Ge Yanlei;Dong Aiying;Li Juan(North China University of Science and Technology Affiliated Hospital,Tangshan 063000,China;National Institute for Communicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention/National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases,Beijing 102206,China)

机构地区：[1]华北理工大学附属医院,唐山063000 [2]中国疾病预防控制中心传染病预防控制所细菌耐药控制室,传染病溯源预警与智能决策全国重点实验室,北京102206

出　　处：《中华预防医学杂志》2024年第6期891-897,共7页Chinese Journal of Preventive Medicine

基　　金：“十三五”传染病重大专项“病原菌耐药性检测监测关键技术及传播规律研究”(2018ZX10733-402)。

摘　　要：研究呼吸道标本来源无乳链球菌的药物敏感性、克隆群、血清型和表面蛋白、毒力基因的携带状况,分析其流行分布、耐药和毒力特征。从唐山、济南2地3家医院共收集到符合标准的无乳链球菌35株。患者的年龄跨度为3 d~92岁,≥60岁的老年患者占比为71.5%。采用微量肉汤稀释法测定其对9种抗菌药物的敏感性,菌株对青霉素、利奈唑胺、万古霉素和头孢曲松100.0%敏感;对红霉素、克林霉素和左氧氟沙星的耐药率高,分别为97.1%、85.7%和82.9%;四环素和氯霉素的耐药率分别为34.3%和14.2%。基因组序列测定及分析显示:35株菌株中检出16种耐药基因,其中:大环内酯类和林可酰胺类药物耐药基因以ermB为主,携带率为74.2%;四环素类耐药基因以tetM为主,携带率为25.7%;此外,喹诺酮类药物耐药决定簇gyrA和parC的突变率分别为88.5%和85.7%。35株菌株分属于6种ST型和4个克隆群,以CC10/ST10为主,占比为62.8%;包含Ⅰb、Ⅱ、Ⅲ和Ⅴ型4种血清型以及1株未分型,以血清型Ⅰb为主,占65.7%。菌株分别携带PI1+PI2a、PI2a和PI2b型3种类型的菌毛,检测到alpha、alp1、rib、srr和rdf_05945种表面蛋白和cba、cfb、cylE、fbsA、hylB、lmb和pavA 7种毒力因子。综上,呼吸道标本来源的无乳链球菌主要分离自老年患者,以CC10菌株为主,携带多种耐药基因和毒力基因,对大环内酯类、林可酰胺类和喹诺酮类药物耐药率高,提示需要密切关注老年患者呼吸道标本中无乳链球菌对健康的威胁。To study the carriage status of drug susceptibility,clonal complex groups,serotypes,surface proteins and virulence genes of Streptococcus agalactiae from respiratory specimen sources.A total of 35 strains of S.agalactiae meeting the criteria were collected from 3 hospitals in 2 locations,Tangshan and Jinan.The age span of the patients was 3 days-92 years,and the percentage of elderly patients≥60 years was 71.5%.The susceptibility to 9 antimicrobial drugs was measured and analyzed using the micro broth dilution method.The strains were 100.0%sensitive to penicillin,linezolid,vancomycin,and ceftriaxone;However,it exhibits high resistance rates to erythromycin,clindamycin and levofloxacin,at 97.1%,85.7%and 82.9%respectively;and the resistance rates to tetracycline and chloramphenicol were 34.3%and 14.2%,respectively.Genome sequence determination and analysis showed that 16 resistance genes were detected in 35 strains,among which:macrolide and lincosamide resistance genes were mainly ermB,with a carrying rate of 74.2%;tetracycline resistance genes were mainly tetM,with a carrying rate of 25.7%;in addition,the mutation rates of the quinolone resistance determinants gyrA and parC were 88.5%and 85.7%,respectively.35 strains belonged to 6 ST types and 4 clonal groups,with CC10/ST10 as the main one,accounting for 62.8%;they contained 4 serotypes ofⅠb,Ⅱ,Ⅲ,andⅤ,as well as 1 untyped strain,with serotypeⅠb as the main one,accounting for 65.7%.The strains carried three pilus types,PI1+PI2a,PI2a and PI2b types,respectively,and detected five surface proteins,alpha,alp1,rib,srr,and rdf_0594,and seven virulence factors,cba,cfb,cylE,fbsA,hylB,lmb,and pavA.Overall,S.agalactiae isolated from respiratory tract specimens is predominantly sourced from elderly patients,with CC10 strains being most prevalent.These strains harbor multiple drug-resistant and virulence genes,demonstrating elevated resistance rates to macrolides,lincosamides,and quinolones.This emphasizes the necessity for vigilant attention to the health threat po

关 键 词：无乳链球菌 血清型 基因 耐药性 监测 

分 类 号：R446.5[医药卫生—诊断学]