Açikgöz Ziya Cibali, Göçer Safiye, Almayanlar Ebru
Fatih Universitesi Tip Fakültesi, Mikrobiyoloji ve Klinik Mikrobiyoloji Anabilim Dali, Ankara.
Mikrobiyol Bul. 2003 Apr-Jun;37(2-3):117-24.
Group G streptococci (GGS) are among the bacterial causes of pharyngitis. In this study, a total of 57 GGS strains isolated from throat swabs were initially screened by NCCLS disk diffusion test for penicillin and erythromycin susceptibilities. Phenotypes of the erythromycin resistance were determined by a triple-disk test and the responsible genes were sought by polymerase chain reaction (PCR) using mefA, ermA, ermA-subclass ermTR and ermB primer sets. Erythromycin and clindamycin minimal inhibitory concentrations (MIC) of the resistant isolates were measured by NCCLS agar dilution method, while susceptibility rates to some other antibiotics were determined by the disk diffusion test. All isolates were found susceptible to penicillin, and 8 (14%) were resistant to erythromycin. Of the resistant isolates, 3 (37.5%) expressed M phenotype and 5 (62.5%) had inducible macrolide-lincosamide-streptogramine B resistance (iMLS). All M isolates had mefA determinant. Of non-M isolates, 3 (37.5%) had subclass ermTR. In 2 (25%) isolates none of the four gene determinants was detected. MIC ranges of erythromycin and clindamycin for M and iMLS phenotypes were 4, 4-128 micrograms/ml and < or = 0.06-0.125, 0.25 - > or = 128 micrograms/ml, respectively. All the erythromycin-resistant isolates were also resistant to tetracycline. The high macrolide-resistance rate of GGS in our hospital deserves attention, however this finding should be confirmed by multi-centre studies including more representative isolates.
G 群链球菌(GGS)是咽炎的细菌病因之一。在本研究中,对从咽拭子中分离出的 57 株 GGS 菌株最初通过 NCCLS 纸片扩散试验筛选其对青霉素和红霉素的敏感性。通过三联纸片试验确定红霉素耐药表型,并使用 mefA、ermA、ermA 亚类 ermTR 和 ermB 引物对通过聚合酶链反应(PCR)寻找相关基因。耐药菌株的红霉素和克林霉素最低抑菌浓度(MIC)通过 NCCLS 琼脂稀释法测定,而对其他一些抗生素的敏感率通过纸片扩散试验确定。所有分离株均对青霉素敏感,8 株(14%)对红霉素耐药。在耐药分离株中,3 株(37.5%)表现为 M 表型,5 株(62.5%)具有诱导型大环内酯 - 林可酰胺 - 链阳菌素 B 耐药(iMLS)。所有 M 型分离株均有 mefA 决定簇。在非 M 型分离株中,3 株(37.5%)有 ermTR 亚类。在 2 株(25%)分离株中未检测到四种基因决定簇中的任何一种。M 型和 iMLS 表型的红霉素和克林霉素 MIC 范围分别为 4、4 - 128 微克/毫升和≤0.06 - 0.125、0.25 - ≥128 微克/毫升。所有红霉素耐药分离株也对四环素耐药。我院 GGS 的高大环内酯耐药率值得关注,然而这一发现应通过包括更具代表性分离株的多中心研究来证实。