临床分离的肺炎链球菌耐药性分析及多位点序列分型

发布时间：2018-04-18 18:13

  本文选题：肺炎链球菌 + 耐药性　； 参考：《中国抗生素杂志》2016年01期

【摘要】：目的了解泉州地区临床分离的肺炎链球菌(Streptococcus pneumoniae,SP)的耐药性特征及多位点序列分型(multilocus sequence type,MLST)。方法针对45株临床分离的SP用E-test法和纸片扩散法检测菌株对14种常用抗菌素的敏感性,以PCR方法检测耐药基因erm B、mef E、mef A及转座子家族int Tn916/Tn1545转座酶基因,采用多位点序列分型(MLST)技术分析菌株序列型(ST)。结果 SP对红霉素、克林霉素、复方磺胺甲VA唑、四环素、青霉素、头孢噻肟、头孢吡肟、美罗培南、阿莫西林、氯霉素、左氧氟沙星的耐药率分别97.8%、93.3%、73.3%、82.2%、26.7%、44.4%、42.1%、26.7%、24.4%、11.1%和4.4%,未见对替考拉宁、利奈唑胺和万古霉素的耐药性;耐药基因erm B、mef E、mef A及转座子家族int Tn916/Tn1545转座酶检出率分别为97.78%、51.11%、44.44%和91.11%;MLST共分出21个ST型,存在一个优势型别ST271,占44.4%(20/45);ST271在mef耐药基因检出率要高于其它散在STs,差异具有统计学意义(P0.05)。结论本地区分离的SP耐药较为严重,且更多的表现为多重耐药;耐药机制主要表现为erm B编码的23S r RNA甲基化酶致靶位改变以及int Tn916/Tn1545接合性转座子介导的耐药传播;ST271是本地区分离SP的主要ST型,并且以多重耐药为主。
[Abstract]:Objective to investigate the clinical isolates of Streptococcus pneumoniae in Quanzhou area (Streptococcus pneumoniae SP) resistance characteristics and multilocus sequence typing (multilocus sequence type, MLST SP). Methods for 45 clinical isolates by E-test method and disk diffusion method was used to detect the sensitivity of strains to 14 common antibiotics, using PCR method to detect ERM gene B, MEF E, MEF A and int Tn916/Tn1545 transposon family transposase gene, multilocus sequence typing (MLST) analysis of strain sequence type (ST). The SP of erythromycin, clindamycin, sulfonyl amine compound VA triazole, tetracycline, penicillin, cefotaxime, cefepime and meropenem, amoxicillin, chloramphenicol, levofloxacin resistance rate were 97.8%, 93.3%, 73.3%, 82.2%, 26.7%, 44.4%, 42.1%, 26.7%, 24.4%, 11.1% and 4.4%, there was no resistance to teicoplanin, linezolid and vancomycin resistance gene; ERM B, MEF E, MEF A and int Tn916/Tn1545 transposon family transposase detection rates were 97.78%, 51.11%, 44.44% and 91.11%; MLST were divided into 21 ST types, there is an advantage of type ST271, accounting for 44.4% (20/45); ST271 in MEF resistance gene detection rate is higher than the other scattered in STs, the difference was statistically significant (P0.05) SP. Conclusion the local resistance is more serious, and more performance for multi drug resistance; resistance mechanism mainly for the ERM B encoding 23S R RNA methylation enzymes induced by target changes and int Tn916/Tn1545 joint resistance transmission of transposon mediated; ST271 is the main ST SP separation in the region and, to multi drug resistance.

【作者单位】： 泉州医学高等专科学校基础医学部;福建医科大学附属泉州市第一医院检验科;福建医科大学附属第二医院检验科;
【基金】：泉州市科技计划项目(No.2012Z73) 福建省卫生厅青年课题(No.2012-1-42) 2014年中共泉州市委组织部优秀人才培养专项项目
【分类号】：R440
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本文编号：1769492