孕晚期妇女产道定植性B群链球菌的耐药性及耐药机制研究

发布时间：2018-01-28 22:39

本文关键词： 无乳链球菌孕妇定植耐药耐药机制　出处：《四川大学学报(医学版)》2015年05期 　论文类型：期刊论文

【摘要】：目的了解孕晚期妇女产道内B群链球菌(group Bstreptococci,GBS)的耐药现状和相关耐药机制,为国内孕妇产道GBS预防治疗及抗生素的合理应用提供理论及数据支持。方法纳入31例产道有GBS定植的孕晚期妇女,对分离出的GBS菌株进行药物敏感实验,对红霉素和克林霉素耐药的菌株进行耐药表型分析和耐药基因检测。结果 21株(67.7%)对红霉素耐药,12株(38.7%)对克林霉素耐药,其中有12株为固有型耐药表型(cMLS型),9株为主动外排型耐药表型(MS型)。在红霉素耐药菌株中有11株检测到mef(A)基因,12株检测到erm(B)基因,其中有3株同时检测到erm(C)基因。结论孕晚期妇女产道内分离出的GBS菌株对大环内酯类抗生素耐药率较高,对红霉素耐药的GBS菌株的耐药机制以erm(B)基因介导的核糖体靶位改变和mef(A)基因介导的特异大环内酯类外排机制增强为主。
[Abstract]:Objective to investigate the drug resistance status of group B streptococcus spp. GBSin late pregnant women and its related drug resistance mechanism. To provide theoretical and data support for the prevention and treatment of GBS and rational use of antibiotics for pregnant women in the birth canal in China. Methods 31 pregnant women with GBS implantation in the delivery canal were included. The drug resistance phenotypic analysis and gene detection of erythromycin and clindamycin resistant strains of GBS strains were carried out. Results 21 strains were resistant to erythromycin. 12 strains were resistant to clindamycin and 12 of them were resistant to clindamycin. Among the 9 strains of Erythromycin resistant strains, 11 strains were identified with MEF A) gene and 12 strains with ermtrichum B) gene were detected in 9 strains with active efflux resistance phenotype (MS-type) and Erythromycin resistant strain (Erythromycin resistant strain). Three of them also detected ermmonia C) gene. Conclusion the resistance rate of GBS strains isolated from the birth canal of late pregnant women to macrolide antibiotics is higher. The mechanisms of resistance to erythromycin resistant GBS were ermbus-B) gene mediated ribosomal target change and the enhancement of specific macrolide efflux mediated by MEF A gene.
【作者单位】：四川大学华西第二医院临床检验科;
【分类号】：R714.25;R446.5
【正文快照】： B群链球菌(group Bstreptococci,GBS)又名无乳链球菌(Streptococcus agalactiae),是一种革兰阳性的β溶血性链球菌,是通过母婴垂直传播、导致新生儿感染的重要的条件致病菌[1]。近年来,临床分离的GBS对红霉素、克林霉素的耐药率不断增加,耐药菌株成全球性分布[2],为GBS的预防

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