摘要
目的 了解杭州地区肺炎链球菌临床株的耐药性及青霉素耐药株的分子流行病学特征。方法 用E- test法测定菌株对青霉素的最低抑菌浓度(MIC),用纸片扩散法测定肺炎链球菌对其他8种抗生素的耐药情况。并以盒式聚合酶链反应(PCR)和青霉素结合蛋白(PBP)基因指纹等分子生物学方法分析菌株间的亲缘关系。结果 临床分离得到肺炎链球菌331 株,E test法测得55 株(16.6%)青霉素高度耐药株(PRSP),127株(38.4%)青霉素中度耐药株(PISP)。纸片扩散法测得氨苄西林、复方新诺明、红霉素、四环素、利福平、氯霉素的耐药率分别为1.2%、47.7%、90%、84.3%、0.3%及13%。所有菌株对氧氟沙星、万古霉素敏感。保存存活的35 株PRSP 可分为17 种盒式PCR谱型,PBP2X、PBP2B、PBP1A的指纹各为5 种、7 种、5 种。盒式谱型A、H的菌株其耐药谱、MIC值和PBP基因指纹高度一致。结论 杭州地区肺炎链球菌临床株的青霉素耐药率较高,非β- 内酰胺类红霉素、四环素、复方新诺明的耐药率亦较高。杭州地区可能有耐药克隆的流行。
Objective To investigate antibiotic resistance of Streptococcus pneumoniae of clinical isolates in Hangzhou and molecular epidemiology of penicillin-resistant pneumococci strains. Methods The E test was applied to determine the minimal inhibitory concentrations of penicillin. A disk diffusion test was applied to detect the antimicrobial susceptibility of S.pneumoniae to eight antibio-tics. BOX-PCR and PBP fingerprint techniques were used to analyze the homology among strains. Results Among 331 Pneumococci from different specimens, 55(16.6%) strains were resistant to Penicillin and 127(38.4%) strains were intermediate. The resistant rates of Ampicillin, Trimethoprim-sulfamethoxazole, Erythromycin, Tetracycline, Rifampin, Chloramphenicol were 1.2%, 47.7%, 90%, 84.3%, 0.3% and 13%, respectively. All of the strains were susceptible to Ofloxacin and Vancomycin. Among the 35 survived PRSP Strains, 17 BOX-PCR clusters were identified, whereas the fingerprint patters were 5 types (PBP2X),7 types (PBP2B) and 5 types (PBP1A), respectively. The resistance patterns, MIC, PBP fingerprints of BOX type A and H stains were highly consistent. Conclusions The resistant rate of Streptococcus pneumoniae to penicillin is very high, and also high to Erythromycin, Tetracycline and Trimethoprim-sulfamethoxaol. There could be a prevalence of some resistant clones in Hangzhou.
出处
《中华传染病杂志》
CAS
CSCD
北大核心
2005年第1期28-31,共4页
Chinese Journal of Infectious Diseases
