摘要
目的:探讨儿科β-内酰胺类抗生素耐药肺炎链球菌分子分型及传播机制。方法:收集2014年7月至2015年7月医院儿科分离的73株肺炎链球菌,采用E-TEST法检测菌株对青霉素钠、头孢呋辛钠、头孢曲松钠、头孢吡肟、阿莫西林、莫西沙星、美罗培南、氨曲南等8种β-内酰胺类抗生素的敏感性,采用PCR扩增肺炎链球菌pbp2X、pbp1A、pbp2B基因,并与Gen Bank标准菌株R6序列进行比较,筛选实验菌株的基因突变信息;限制性片段长度多态性(RFLP)分析耐药菌株的分子分型。结果:肺炎链球菌对头孢曲松耐药最高(82.2%),其次为头孢呋辛(69.8%)和青霉素(43.8%),对莫西沙星(1.4%)和阿莫西林(4.1%)耐药率较低。根据肺炎链球菌耐药情况分为敏感组(12株)、中介组(29株)和耐药组(32株)。pbp2X基因中,耐药组突变率显著高于中介组和敏感组(P<0.05),中介组突变率又显著高于敏感组(P<0.05);pbp1A基因中,耐药组突变率显著高于中介组和敏感组(P<0.05),中介组突变率又显著高于敏感组(P<0.05);pbp2B基因中,耐药组、中介组突变率显著高于敏感组(P<0.05),中介组与耐药组突变率比较差异无统计学意义(P>0.05)。32株青霉素耐药株中有23株为A2-B1-X5型,提示部分多药耐药株可能存在克隆传播。结论:儿科分离的肺炎链球菌对β-内酰胺类抗生素耐药现象严重,pbp2X、pbp1A、pbp2B基因突变与耐药发生有关,在小范围内存在青霉素耐药株的克隆传播。
Objective： To explore the drug resistant molecular type and transmission mechanism of Streptococcus pneumoniae isolate from pediatric department.Methods： A total of 73 strains of streptococcus pneumoniae isolated from pediatric department from July 2014 to July 2015 were selected,the bacteria to penicillin sodium, cefuroxime, cefotaxime ceftriaxone sodium, cefotaxime cefepime, amoxicillin, moxifloxacin, meropenem, aztreonam antibiotics sensitivity was detected by E-test method,pbp1A, pbp2X, pbp2B gene was amplified by PCR method,and compared with the GenBank standard strain R6 sequence, the gene mutation information of the experimental strains was screened, the molecular type of drug resistant strains was analysed by restriction fragment length polymorphism （RFLP）.Results： Streptococcus pneumoniae resistance to ceftriaxone in the highest,was 82.2%,followed by penicillin （69.8%） and cefuroxime（43.8%）.Streptococcus pneumoniae resistance to moxifloxacin （1.4%）and amoxicillin （4.1%） in the lowest.Streptococcus pneumoniae was divided into sensitive group 12 strains,intermediate group 29 strains and resistant group 32 strains.In pbp2X gene,the mutation rate of resistant group was significantly higher than that in the intermediate group and the sensitive group （P〈0.05）, and the mutation rate of the intermediate group was significantly higher than that of the sensitive group（P〈0.05）.In pbp1A gene,the mutation rate of resistant group was significantly higher than that in the intermediate group and the sensitive group （P〈0.05）, and the mutation rate of the intermediate group was significantly higher than that of the sensitive group（P 〈 0.05）.In pbp2B gene, the mutation rate of resistant group and intermediate group was significantly higher than that in the susceptible group （P〈0.05）,there was no significant difference of mutation rate between the intermediate group and the resistant strain （P〉0.05）.23 strin were A2-B1-X5 type in 32 strains of penicillin resistan
作者
周会霞
杨广龙
李银华
刘敏
ZHOU Hui-xia YANG Guang-long LI Yin- hua LIU Min(Infection Management Section, the First People＇s Hospital of Tianmen City, Tianmen 431700, China Department of Cardiology, the First People＇ s Hospital of Tianmen City, Tianmen 431700, China Department of Pediatrics, the First People＇ s Hospital of Tianmen City, Tianmen 431700, China Department of Pediatrics, Zhongnan Hospital of Wuhan University, Wuhan 430071, China)
出处
《现代医学》
2017年第2期215-220,共6页
Modern Medical Journal
关键词
儿科
肺炎链球菌
耐药菌株
Β-内酰胺类抗生素
克隆传播
pediatric department
Streptococcus pneumoniae
resistant strains
β- lactam antibiotics
clone dissemiantion
