肺炎链球菌耐药性检测及其对大环内酯类抗生素耐药机制的研究

目的了解浙江地区肺炎链球菌临床菌株对临床常用抗生素耐药性以及肺炎链球菌对大环内酯类抗生素耐药机制。方法从浙江省不同地区病人临床标本中分离并鉴定肺炎链球菌138株。采用K-B纸片法和E-test检测上述肺炎链球菌临床菌株对9种抗生素的敏感性。采用PCR检测上述菌株中与大环内酯类抗生素耐药性密切相关的ermB和mefE基因携带情况。分析ermB和mefE基因携带、分布状况与红霉素耐药性关系。结果138株肺炎链球菌临床菌株中,对红霉素耐药率高达93.5%(129/138),对头孢噻肟、头孢呋辛、阿莫西林和左氧氟沙星的耐药率较低(2.9%~4.3%)。上述菌株er-mB基因检测阳性率(91.3%,126/138)明显高于mefE基因(33.3%,46/138)(P0.05),其中27.5%菌株(38/138)同时携带。不携带ermB和mefE基因菌株均对红霉素敏感,仅携带mefE基因菌株对红霉素耐药率(62.5%)明显低于同时携带两种基因菌株耐药率(100%)及仅携带ermB基因菌株耐药率(97.7%)(P0.05)。结论红霉素已不适合作为治疗肺炎链球菌感染性疾病的药物。ermB基因是肺炎链球菌临床菌株携带的红霉素耐药相关优势基因。ermB基因可使肺炎链球菌产生较mefE基因更强的红霉素耐药性。

Resistance detection and macrolide antibiotic-resistant mechanism of Streptococcus pneumoniae isolates

In order to understand the resistance against common antibiotics in clinic and macrolide antibiotic-resistant mechanism of Streptococcus pneumoniae(S.pneumoniae) isolates in Zhejiang area,both K-B slip method and E-test were applied to determine the sensitivity of 138 S.pneumoniae isolates to nine antibiotics,and the ermB and mefE genes in those isolates which associated with macrolide antibiotics-resistance closely were detected by PCR.Subsequently,correlation among ermB and mefE genes and the erythromycin...