在雅典地区分离出的耐药和多重耐药肺炎链球菌菌株与国际克隆株的遗传相关性。

Tsolia Maria N, Stamos George, Ioannidou Sophia, Trefler Ronit, Foustoukou Maria, Kafetzis Dimitris, Porat Nurith

Second Department of Pediatrics, University of Athens School of Medicine, P. and A. Kyriakou Children's Hospital, Greece.

Microb Drug Resist. 2002 Fall;8(3):219-26. doi: 10.1089/107662902760326940.

The prevalence of resistance to antibiotics was examined among 318 Streptococcus pneumoniae strains isolated during 1998 and 1999 in a children's hospital in Athens. The rate of resistance to penicillin was 25.8% (intermediate 22%, resistant 3.8%); 42.5% of the strains were resistant to > or = 1 antibiotic and 20% were multidrug resistant. Resistance to penicillin was lowest in invasive strains (8.3%) and highest in ear isolates (31%). A review of the same microbiology laboratory's records revealed that there has been a gradual increase in penicillin resistance since 1988-1989, when it was 5%. Capsular types were determined for 77 strains resistant to > or = 1 antibiotic, and 69 (90%) of them belonged to the following five serotypes: 19F, 14, 9V, 23F, and 6B. Seventy-five strains were analyzed by pulsed-field gel electrophoresis (PFGE) and 59/75 (79%) shared five electrophoretic types. The largest cluster consisted of 19 serotype 19F strains, of which 18 were nonsusceptible to penicillin and most were multidrug resistant and shared a common and distinct electrophoretic pattern not resembling any known clone. A group of 17 strains that were nonsusceptible to penicillin belonged to serotypes 9V (10), 14 (6), and 19F (1) and shared a common PFGE type similar to the international clone Spain9V-3. Seven serotype 23F strains, of which five were multidrug resistant, belonged to the international clone Spain23F-1. Among the strains susceptible to penicillin but resistant to non-beta-lactam antibiotics, the largest cluster consisted of 13 isolates resistant to erythromycin that belonged to serotype 14 and shared an electrophoretic pattern characteristic of the clone England14-9. Finally, three serotype 6B strains were penicillin susceptible and multidrug resistant and had features similar to the Mediterranean 6B clone. The introduction and spread of several antibiotic-resistant international clones accounts at least in part for the increase in pneumococcal resistance observed in recent years in the Athens metropolitan area.

1998年至1999年期间，在雅典一家儿童医院分离出318株肺炎链球菌，对这些菌株的抗生素耐药性进行了检测。对青霉素的耐药率为25.8%（中介耐药22%，耐药3.8%）；42.5%的菌株对≥1种抗生素耐药，20%为多重耐药。侵袭性菌株对青霉素的耐药性最低（8.3%），耳部分离株最高（31%）。对同一微生物实验室记录的回顾显示，自1988 - 1989年（当时为5%）以来，青霉素耐药性呈逐渐上升趋势。对77株对≥1种抗生素耐药的菌株进行了荚膜分型，其中69株（90%）属于以下五种血清型：19F、14、9V、23F和6B。通过脉冲场凝胶电泳（PFGE）分析了75株菌株，59/75（79%）共有五种电泳类型。最大的一簇由19株19F血清型菌株组成，其中18株对青霉素不敏感，大多数为多重耐药，且具有一种共同且独特的电泳图谱，与任何已知克隆均不相似。一组17株对青霉素不敏感的菌株属于9V（10株）、14（6株）和19F（1株）血清型，共有一种与国际克隆Spain9V - 3相似的PFGE类型。7株23F血清型菌株中，5株为多重耐药，属于国际克隆Spain23F - 1。在对青霉素敏感但对非β - 内酰胺类抗生素耐药的菌株中，最大的一簇由13株对红霉素耐药的分离株组成，它们属于14血清型，具有与克隆England14 - 9特征相似的电泳图谱。最后，3株6B血清型菌株对青霉素敏感但为多重耐药，具有与地中海6B克隆相似的特征。几种耐抗生素国际克隆的引入和传播至少部分解释了近年来在雅典大都市地区观察到的肺炎球菌耐药性增加的现象。