Richter S S, Heilmann K P, Coffman S L, Huynh H K, Brueggemann A B, Pfaller M A, Doern G V
Medical Microbiology Division, Department of Pathology, University of Iowa College of Medicine, Iowa City, IA 52242, USA.
Clin Infect Dis. 2002 Feb 1;34(3):330-9. doi: 10.1086/338065. Epub 2001 Dec 17.
The genetic relatedness of 672 penicillin-resistant isolates of Streptococcus pneumoniae (PRSP) recovered during national surveillance studies conducted in the United States during the periods of 1994-1995, 1997-1998, and 1999-2000 was determined by use of pulsed-field gel electrophoresis (PFGE). Overall, 104 different PFGE types were elucidated. For all study periods combined, the 12 most prevalent PFGE types included >75% of all isolates, and 5 types were closely related to widespread clones (Spain(23F)-1, France(9V)-3, Spain(6B)-2, Tennessee(23F)-4, and Taiwan(19F)-14). From 1994-1995 to 1999-2000, 3 major PFGE types (not closely related to 16 recognized clones) increased in prevalence. Multidrug resistance was identified among 96%-100% of the isolates in 9 of 12 predominant PFGE types. The prevalence of erythromycin resistance increased within 4 major PFGE types. These observations support the hypothesis that the dominant factor in the emergence of PRSP in the United States during the 1990s has been human-to-human spread of relatively few clonal groups that harbor resistance determinants to multiple classes of antibiotics.
在1994 - 1995年、1997 - 1998年以及1999 - 2000年期间于美国开展的全国监测研究中，共收集到672株耐青霉素肺炎链球菌（PRSP），采用脉冲场凝胶电泳（PFGE）方法测定了它们的遗传相关性。总体而言，共阐明了104种不同的PFGE型别。在所有研究期间，12种最常见的PFGE型别涵盖了所有分离株的75%以上，其中5种与广泛传播的克隆密切相关（西班牙（23F）- 1、法国（9V）- 3、西班牙（6B）- 2、田纳西（23F）- 4以及台湾（19F）- 14）。从1994 - 1995年到1999 - 2000年，3种主要的PFGE型别（与16种已确认的克隆无密切关系）的流行率有所上升。在12种主要PFGE型别的9种中，96% - 100%的分离株具有多重耐药性。4种主要PFGE型别中红霉素耐药性的流行率有所上升。这些观察结果支持这样一种假设，即20世纪90年代美国耐青霉素肺炎链球菌出现的主导因素是相对少数携带多种抗生素耐药决定簇的克隆群体在人与人之间的传播。
