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卢添林, 曹韵, 周玲旭等. 73株婴幼儿呼吸道肺炎链球菌分离株耐药性研究[J]. koko体育app 学报(医学版), 2015, 46(3): 417-421.
引用本文: 卢添林, 曹韵, 周玲旭等. 73株婴小孩子吸气道肺气肿链球菌提取株抗药力性钻研[J]. 江西本科大学学报(临床版), 2015, 46(3): 417-421.
LU Tian-lin, CAO Yun, ZHOU Ling-xu. et al. The Antimicrobial Resistance Analysis of 73 Strains of Streptococcus pneumoniae Isolated from InfantRespiratory Tract[J]. Journal of Sichuan University (Medical Sciences), 2015, 46(3): 417-421.
Citation: LU Tian-lin, CAO Yun, ZHOU Ling-xu. et al. The Antimicrobial Resistance Analysis of 73 Strains of Streptococcus pneumoniae Isolated from InfantRespiratory Tract[J]. Journal of Sichuan University (Medical Sciences), 2015, 46(3): 417-421.

73株婴幼儿呼吸道肺炎链球菌分离株耐药性研究

The Antimicrobial Resistance Analysis of 73 Strains of Streptococcus pneumoniae Isolated from InfantRespiratory Tract

  • 摘要: 目的 通过对73株婴幼儿呼吸道肺炎链球菌耐药表型和基因的测定,初步探讨本地区肺炎链球菌耐药机制。方法 采用K-B药敏纸片扩散法和微量肉汤稀释法对73株婴幼儿呼吸道肺炎链球菌进行药敏试验,分析其对青霉素、左氧氟沙星等12种抗生素的耐药情况;通过PCR方法检测73株肺炎链球菌携带四环素耐药基因tet M,大环内酯-林可酰胺-链阳菌素B(MLSB)类抗生素耐药基因mef A、erm A和erm B,转座子整合酶基因int Tn的情况。结果 纸片扩散法结果显示73株肺炎链球菌对红霉素、克林霉素及四环素的耐药率较高,分别达到95.9%、94.5%、87.7%;没有检出耐万古霉素肺炎链球菌;微量肉汤稀释法结果显示73株肺炎链球菌对青霉素、头孢噻肟、头孢曲松3种抗生素敏感率比较一致,分别为45.2%、47.9%、46.6%;73株肺炎链球菌tet M、mef A、erm A、erm B、int Tn基因携带率分别为91.8%、63.0%、58.9%、39.7%、61.6%。结论 成都市婴幼儿呼吸道肺炎链球菌分离株对青霉素、四环素、红霉素及头孢菌素类临床常用抗生素的耐药率较高,对左氧氟沙星、氯霉素的耐药率则保持在较低水平;肺炎链球菌分离株四环素耐药与tet M携带关系密切;对大环内酯类药物的耐药由主动外排泵和靶位改变造成,其中以前者为主;int Tn与tet M、erm B基因关系密切。  
    Abstract: Objective To preliminary study of the resistance mechanisms of S.pneumoniae(S.pn) by determining the resistance rates and gene of S.pn isolated from the lower respiratory tract infection infants. Methods Drug susceptibility test with disk diffusion and broth micro-dilution was conducted to evaluate the resistance rates of 73 strains of S.pn isolated from the lower respiratory tract infection infants to penicillin, levofloxacin and other 10 antibiotics. PCR method was used to analysis the antimicrobial resistant genes tet M, mef A, erm A, erm B and int Tn of the isolates. Results The antibiotic resistance rates of the S.pn isolates to erythromycin, clindamycin and tetracycline were 95.9%, 94.5%, 87.7% and 0% to vancomycin when tested with disk diffusion method. The antibiotic resistance rates of these isolates to penicillin, cefotaxime and ceftriaxone were 45.2%, 47.9% and 46.6% respectively when tested with broth micro-dilution method. The carrier frequencies of tet M, mef A, erm A, erm B, int Tn genes in the 73 isolates were 91.8%, 63.0%, 58.9%, 39.7% and 61.6% respectively. Conclusion The S.pn strains isolated from infant respiratory tract in Chengdu perform a serious drug resistance problem, especially to routine antibiotics like erythromycin, clindamycin and tetracycline and cephalosporin, the resistance rate to levofloxacin, chloramphenicol remained at a low level; the resistance to tetracycline was closely related with the tet M gene fragment, the resistance to macrolide was mainly decided by active efflux pump and secondarily by the alternation of gene targeting, int Tn had close relation with tet M, erm B.  
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