Wang H, Chen M, Huebener R
Peking Union Medical College Hospital, Beijing 100730.
Zhonghua Yi Xue Za Zhi. 1999 Apr;79(4):253-6.
To investigate antimicrobial resistance of Streptococcus pneumoniae in Beijing and molecular epidemiology of penicillin-resistant pneumococci strains.
The resistance to beta-lactam and non-beta-lactam antibiotics of 244 nasopharyngeal isolates of Streptococcus pneumoniae collected from September to November 1997 in 8 day-care centers in Beijing was studied by Etest and agar dilution method. Serotyping was done by "capsular swelling" technique. BOX-PCR technique was used to detect the DNA of resistant strains.
24.8% (244/985) of the children carried Streptococcus pneumoniae. The agreement between the MICs obtained by Etest and agar dilution for penicillin and ceftriaxone was > 93.7%. By Etest, 3/244 (1.3%) strains were resistant to penicillin(MICs, 3 micrograms/ml) and 32/244(13.1%) strains in termedinte (MICs, 0.094-0.25 microgram/ml). Penicillin-susceptible strains were also susceptible to the other 4 tested beta-lactams. In penicillin non-susceptible strains, 11.4% (4/35) isolates were resistant to the other beta-lactams. The resistant rates of erythromycin, tetracycline, chloramphenicol and trimethoprim-sulfamethoxazole (TMP-SMZ) were 74.0%, 87.6%, 47.8%, 63.3%, respectively. All of the strains were susceptible to vancomycin and rifampin. 119/244(48.7%) strains isolated were multiresistant to tetracycline, erythromycin and TMP/SMZ. Serotype 6A(33.6%), 19F(16.8%), 23F(15.1%), 15(11.2%), 6B(4.3%) were most common. 57.1% (20/35) penicillin non-susceptible strains were of serotype 23F and had similar or identical multiresistance and BOX patterns.
In Beijing, the prevalence of penicillin-resistant pneumococci was obviously lower than that of neighboring countries, but resistant rate to non-beta-lactams was high. The epidemic multiresistant 23F clone found in day-care centers was different from the Spanish clone.
研究北京地区肺炎链球菌的耐药性及耐青霉素肺炎链球菌菌株的分子流行病学特征。
采用Etest法和琼脂稀释法,对1997年9月至11月在北京8个日托中心收集的244株肺炎链球菌鼻咽分离株进行β-内酰胺类和非β-内酰胺类抗生素耐药性研究。采用“荚膜肿胀”技术进行血清分型。应用BOX-PCR技术检测耐药菌株的DNA。
24.8%(244/985)的儿童携带肺炎链球菌。Etest法和琼脂稀释法测得的青霉素和头孢曲松的最低抑菌浓度(MIC)之间的一致性>93.7%。采用Etest法,244株中有3株(1.3%)对青霉素耐药(MIC为3μg/ml),32株(13.1%)中介(MIC为0.094~0.25μg/ml)。青霉素敏感菌株对其他4种受试β-内酰胺类抗生素也敏感。在青霉素不敏感菌株中,11.4%(4/35)的分离株对其他β-内酰胺类抗生素耐药。红霉素、四环素、氯霉素和复方新诺明的耐药率分别为74.0%、87.6%、47.8%、63.3%。所有菌株对万古霉素和利福平敏感。分离出的244株中有119株(48.7%)对四环素、红霉素和复方新诺明多重耐药。6A(33.6%)、19F(16.8%)、23F(15.1%)、15(11.2%)、6B(4.3%)血清型最为常见。57.1%(20/35)的青霉素不敏感菌株为23F血清型,具有相似或相同的多重耐药性和BOX图谱。
在北京,耐青霉素肺炎链球菌的流行率明显低于周边国家,但对非β-内酰胺类抗生素的耐药率较高。在日托中心发现的流行多重耐药23F克隆与西班牙克隆不同。