广州地区ermB和mefE基因介导对红霉素耐药的肺炎链球菌及其耐药性分析  

Prevalence of erythomycin-resistant streptococcus pneumoniae mediated by ermB or mef E genes and their variable antimicrobial resistance in Guangzhou

作　　者：周宏[1] 邓力[2] 叶启慈[2] 邓秋连[1] 陈卓瑶[1] 黄旭强[2] 

机构地区：[1]广州市儿童医院检验科,510120 [2]广州市儿童医院呼吸科,510120

出　　处：《中华检验医学杂志》2004年第2期111-113,共3页Chinese Journal of Laboratory Medicine

基　　金：国家自然科学基金资助项目 (3 0 0 70 793 )

摘　　要：目的　了解广州地区对红霉素耐药的肺炎链球菌中ermB及mefE基因分布 ,比较ermB基因与mefE基因对红霉素耐药的肺炎链球菌的耐药性。方法　用克林霉素纸片法检测 199株对红霉素耐药的肺炎链球菌 ,并用浓度梯度法检测其耐药性。结果　 199株对红霉素耐药的肺炎链球菌中 ,ermB、mefE基因介导的耐药率分别为 70 9% (14 1/199)和 2 9 1% (5 8/199)。 14 1株ermB基因介导对红霉素耐药的肺炎链球菌 ,对青霉素 (MIC50 0 19μg/ml、MIC90 1 5 μg/ml)、阿莫西林 /克拉维酸 (MIC500 19μg/ml、MIC90 1 0 μg /ml)、头孢曲松 (MIC50 0 19μg/ml、MIC90 0 75 μg/ml)、头孢呋辛 (MIC50 0 38μg/ml、MIC90 2 0 μg/ml)、头孢克洛 (MIC50 2 0 μg/ml、MIC90 32 0 μg/ml)的不敏感率分别为 5 8 2 %、0 7%、2 1 3%、4 6 1%和 5 1 1%。5 8株mefE基因介导对红霉素耐药的肺炎链球菌 ,对青霉素 (MIC50 0 5 μg/ml、MIC901 5 μg/ml)、阿莫西林 /克拉维酸 (MIC50 0 38μg/ml、MIC90 1 0 μg/ml)、头孢曲松 (MIC50 0 38μg/ml、MIC900 75 μg/ml)、头孢呋辛 (MIC50 1 0 μg/ml、MIC90 3 0 μg/ml)、头孢克洛 (MIC50 6 0 μg/ml、MIC90 4 8 0 μg/ml)的不敏感率分别为 6 7 2 %、0、19 0 %、5 8 6 %和 6 2 1%。?Objectives To investigate the mechanisms of erythomycin- resistant Streptococcus pneumoniae and their variable antimicrobial resistance. Methods Use of clindamycin disks to screen erythomycin-resistant Streptococcus pneumoniae mediated by ermB or mefE genes, Antimicrobial resistance of erythomycin-resistant Streptococcus pneumoniae mediated by ermB or mefE genes were studied by Etest respectively. Results ermB and mefE genes were 70.9% (141/199) and 29.1% (58/199) respectively among 199 strains of erythomycin-resistant Streptococcus pneumoniae. The rates of resistant to penicillin (MIC 50 0.19μg/ml, MIC90 1.5μg/ml), amoxicillin/clavulanic acid (MIC 50 0.19μg/ml, MIC 90 1.0μg/ml), ceftrixone (MIC 50 0.19μg/ml, MIC 90 0.75μg/ml), cefuroxime (MIC 50 0.38μg/ml, MIC 90 2.0μg/ml), cefaclor (MIC 50 2.0μg/ml, MIC 90 32.0μg/ml) of erythomycin-resistant Streptococcus pneumoniae mediated by ermB were 58.2% (82/141), 0.7% (1/141), 21.3% (30/141), 46.1% (65/141), 51.1% (72/141) respectively, and the resistant rates to penicillin (MIC 50 0.5μg/ml, MIC 90 1.5μg/ml), amoxicillin/clavulanic acid (MIC 50 0.38μg/ml, MIC 90 1.0μg/ml), ceftrixone (MIC 50 0.38μg/ml, MIC 90 0.75μg/ml), cefuroxime (MIC 50 1.0μg/ml, MIC 90 3.0μg/ml), cefaclor (MIC 50 6.0μg/ml, MIC 90 48.0μg/ml) of erythomycin-resistant Streptococcus pneumoniae mediated by mefE were 67.2% (39/58), 0, 19.0%(11/58), 58.6% (34/58), 62.1% (36/58) respectively (including decreased susceptibility).Conclusions Erythomycin-resistant Streptococcus pneumoniae mediated by ermB was predominance in Guangzhou; the level of erythomycin resistance mediated by ermB was usually higher than that due to mefE.

关 键 词：ermB mefE 基因介导 红霉素 耐药 肺炎链球菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]