本文選題：肺炎鏈球菌 + 耐藥性�。� 參考：《中國抗生素雜志》2016年01期

【摘要】：目的了解泉州地區(qū)臨床分離的肺炎鏈球菌(Streptococcus pneumoniae,SP)的耐藥性特征及多位點序列分型(multilocus sequence type,MLST)。方法針對45株臨床分離的SP用E-test法和紙片擴散法檢測菌株對14種常用抗菌素的敏感性,以PCR方法檢測耐藥基因erm B、mef E、mef A及轉(zhuǎn)座子家族int Tn916/Tn1545轉(zhuǎn)座酶基因,采用多位點序列分型(MLST)技術(shù)分析菌株序列型(ST)。結(jié)果 SP對紅霉素、克林霉素、復(fù)方磺胺甲VA唑、四環(huán)素、青霉素、頭孢噻肟、頭孢吡肟、美羅培南、阿莫西林、氯霉素、左氧氟沙星的耐藥率分別97.8%、93.3%、73.3%、82.2%、26.7%、44.4%、42.1%、26.7%、24.4%、11.1%和4.4%,未見對替考拉寧、利奈唑胺和萬古霉素的耐藥性;耐藥基因erm B、mef E、mef A及轉(zhuǎn)座子家族int Tn916/Tn1545轉(zhuǎn)座酶檢出率分別為97.78%、51.11%、44.44%和91.11%;MLST共分出21個ST型,存在一個優(yōu)勢型別ST271,占44.4%(20/45);ST271在mef耐藥基因檢出率要高于其它散在STs,差異具有統(tǒng)計學(xué)意義(P0.05)。結(jié)論本地區(qū)分離的SP耐藥較為嚴重,且更多的表現(xiàn)為多重耐藥;耐藥機制主要表現(xiàn)為erm B編碼的23S r RNA甲基化酶致靶位改變以及int Tn916/Tn1545接合性轉(zhuǎn)座子介導(dǎo)的耐藥傳播;ST271是本地區(qū)分離SP的主要ST型,并且以多重耐藥為主。
[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.

【作者單位】： 泉州醫(yī)學(xué)高等�？茖W(xué)�；A(chǔ)醫(yī)學(xué)部;福建醫(yī)科大學(xué)附屬泉州市第一醫(yī)院檢驗科;福建醫(yī)科大學(xué)附屬第二醫(yī)院檢驗科;
【基金】：泉州市科技計劃項目(No.2012Z73) 福建省衛(wèi)生廳青年課題(No.2012-1-42) 2014年中共泉州市委組織部優(yōu)秀人才培養(yǎng)專項項目
【分類號】：R440
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本文編號：1769492