Bogaert D, Hermans P W M, Grivea I N, Katopodis G S, Mitchell T J, Sluijter M, De Groot R, Beratis N G, Syrogiannopoulos G A
Department of Pediatrics, Sophia Children's Hospital, Erasmus MC Rotterdam, 3000 DR Rotterdam, The Netherlands.
J Clin Microbiol. 2003 Dec;41(12):5633-9. doi: 10.1128/JCM.41.12.5633-5639.2003.
A total of 128 Streptococcus pneumoniae isolates that were susceptible to penicillin but resistant to non-beta-lactam agents were isolated from young carriers in Greece and analyzed by antibiotic susceptibility testing, serotyping, restriction fragment end labeling (RFEL), and antibiotic resistance genotyping. The serotypes 6A/B (49%), 14 (14%), 19A/F (11%), 11A (9%), 23A/F (4%), 15B/C (2%), and 21 (2%) were most prevalent in this collection. Of the isolates, 65% were erythromycin resistant, while the remaining isolates were tetracycline and/or trimethoprim-sulfamethoxazole resistant. Fifty-nine distinct RFEL types were identified. Twenty different RFEL clusters, harboring 2 to 19 strains each, accounted for 76% of all strains. Confirmatory multilocus sequence typing analysis of the genetic clusters showed the presence of three international clones (Tennessee(23F)-4, England(14)-9, and Greece(6B)-22) representing 30% of the isolates. The erm(B) gene was present in 70% of the erythromycin-resistant isolates, whereas 18 and 8% contained the mef(A) and mef(E) genes, respectively. The pneumococci representing erm(B), erm(A), and mef genes belonged to distinct genetic clusters. In total, 45% of all isolates were tetracycline resistant. Ninety-six percent of these isolates contained the tet(M) gene. In conclusion, penicillin-susceptible pneumococci resistant to non-beta-lactams are a genetically heterogeneous group displaying a variety of genotypes, resistance markers, and serotypes. This suggests that multiple genetic events lead to non-beta-lactam-resistant pneumococci in Greece. Importantly, most of these genotypes are capable of disseminating within the community.
从希腊的年轻携带者中分离出128株对青霉素敏感但对非β-内酰胺类药物耐药的肺炎链球菌菌株，通过药敏试验、血清分型、限制性片段末端标记（RFEL）和抗生素耐药基因分型进行分析。血清型6A/B（49%）、14（14%）、19A/F（11%）、11A（9%）、23A/F（4%）、15B/C（2%）和21（2%）在该样本中最为常见。在分离株中，65%对红霉素耐药，其余分离株对四环素和/或甲氧苄啶-磺胺甲恶唑耐药。鉴定出59种不同的RFEL类型。20个不同的RFEL簇，每个簇包含2至19个菌株，占所有菌株的76%。对这些基因簇进行的验证性多位点序列分型分析显示存在三个国际克隆（田纳西州（23F）-4、英格兰（14）-9和希腊（6B）-22），占分离株的30%。70%的红霉素耐药分离株中存在erm（B）基因，而分别有18%和8%的分离株含有mef（A）和mef（E）基因。代表erm（B）、erm（A）和mef基因的肺炎链球菌属于不同的基因簇。总体而言，所有分离株中有45%对四环素耐药。这些分离株中有96%含有tet（M）基因。总之，对非β-内酰胺类耐药的青霉素敏感肺炎链球菌是一个基因异质性群体，表现出多种基因型、耐药标记和血清型。这表明在希腊，多种基因事件导致了对非β-内酰胺类耐药的肺炎链球菌。重要的是，这些基因型中的大多数能够在社区内传播。
