摘要
目的对武汉市分离自12~18月龄健康婴幼儿鼻咽部的75株肺炎链球菌(Streptococcus pneumoniae,Spn),进行耐药检测及多位点序列分型(muhilocus sequence typing,MLST),了解该市Spn耐药菌株遗传背景。方法用E-test方法检测菌株对8种抗菌药物的耐药情况,并对多重耐药株进行MLST分型。结果左氧氟沙星(LVX)、莫西沙星(MFX)、头孢曲松(CRO)、青霉素(PEN)及阿莫西林/克拉维酸(AMX)对该组Spn细菌有良好的体外活性,敏感率分别为100.00%,100.00%,88.00%,92.00%,89.30%。此组Spn对阿奇霉素(AZM)和红霉素(ERY)的耐药率很高,分别为90.67%,90.67%。对头孢呋辛(CXM)的耐药率为24.00%。75菌株中24株为多重耐药,以CXM/AZM/ERY多重耐药模式为主。MLST分型表明,ST3173(6)、ST271(4)、ST876(4)、ST3397(3)为多重耐药菌株常见型别。研究得到的12个ST型别中,有4个型别ST271(4)、ST320(2)、ST90(1)、ST1661(1),共8菌株,属于国际流行耐药克隆株克隆株(Pneumococcal molecular Epidemiology Network,PMEN)Taiwan^(19F)-14及Spain^(6B)-2。多重耐药菌株中一株属于新的型别ST6318,与研究中其它ST型存在两个以上等位基因差别。结论武汉市健康婴幼儿Spn分离株中,国际PMEN克隆株的传播对耐药性的增加发挥了重要作用。同时,抗性基因水平转移也促进了耐药性的改变。
Objective To evaluate the antibiotic susceptibility of 75 strains of Streptococcus pneumoniae isolated from Wuhan in2009,and analyze the muhilocus sequence typing（ MLST） of multi-drug resistant strains. Methods Eight kinds of antibiotics,including penicilin（ PEN）, ampicillin-clavulanic acid（ AMX）,cefuroxime（ CXM）, ceftriaxone（ CRO）, levofloxacin（ LVX）,moxifloxacin（ MFX）,azithromycin（ AZM）,and erythromycin（ ERY） were chosen to conduct E-tests. The evolutional relationship of multi-drug resistant strains was investigated by MLST,and the comparison with international epidemic strains was carried out.Results To LVX, MFX, CRO, PEN, AMX, the sensitive rates in vitro were 100%,100%,88. 0%,92. 0%,89. 3%,respectively. The resistant rates to AZM and ERY were very high,both were 90. 7%. 24 strains were multiple drug resistant strains,of which the CXM / AZM / ERY spectrum was the major antibiotic resistance spectrum. The MLST of multi-drug resistant strains demonstrated that ST3173（ 6）,ST271（ 4）,ST876（ 4） and ST3397（ 3） were the major ST categories. Of the 12 type ST in the research,ST271（ 4）,ST320（ 2）,ST90（ 1）,ST1661（ 1） belonged to PMEN clone Taiwan_（19F）- 14 and Spain^（6B）- 2,respectively. A multi drug resistant strain was a new type ST6318,that was more than two alleles different with other ST in this study. Conclusion Isolates of international PMEN（ Pneumococcal Epidemiology Network） clones have become prevalent and the clonal spread has played an important role in the increase in antimicrobial resistance among isolates from Wuhan. At the same time,the horizontal spread of resistance genes has also contributed to the resistance variation.
出处
《公共卫生与预防医学》
2016年第3期43-45,共3页
Journal of Public Health and Preventive Medicine
基金
武汉市卫生局公共卫生科研项目(WG11C03)
关键词
健康婴幼儿
肺炎链球菌
耐药性
多位点序列分型
Healthy infants
Streptococcus pneumoniae
Antibiotics resistance
Muhilocus sequence typing
