Reinert Ralf René, Franken Carmen, van der Linden Mark, Lütticken Rudolf, Cil Murat, Al-Lahham Adnan
Institute for Medical Microbiology, National Reference Center for Streptococci, University Hospital, Pauwelsstrasse 30, D-52057 Aachen, Germany.
Int J Antimicrob Agents. 2004 Jul;24(1):43-7. doi: 10.1016/j.ijantimicag.2004.02.020.
In the present study, a real-time PCR protocol was developed for the detection of macrolide resistance determinants and was validated in a nationwide study in Germany covering a total of 236 Streptococcus pyogenes and 241 Streptococcus pneumoniae strains collected from children < or = 16 years of age with community-acquired infections. Macrolide resistance was observed in 19.9% of pneumococcal strains and 14% of S. pyogenes isolates. Of the erythromycin A-resistant S. pyogenes strains, 93.9% showed the efflux type mef(A); 62.5% of the S. pneumoniae strains were mef(A)- and 37.5% erm(B)-positive. The correlation of the results of real-time PCR assay genotyping in the present study compared with those of conventional PCR genotyping and resistance phenotyping was 100%. Macrolide resistance is of growing concern in Germany. This highly sensitive and specific PCR assay to detect macrolide resistance has the potential to provide sufficiently rapid results to improve antibiotic treatment of streptococcal infections.
在本研究中，开发了一种用于检测大环内酯类耐药决定因素的实时PCR方法，并在德国一项全国性研究中进行了验证，该研究共纳入了236株化脓性链球菌和241株肺炎链球菌，这些菌株均采集自16岁及以下社区获得性感染儿童。在19.9%的肺炎链球菌菌株和14%的化脓性链球菌分离株中观察到大环内酯类耐药。在对红霉素A耐药的化脓性链球菌菌株中，93.9%表现为外排型mef(A)；62.5%的肺炎链球菌菌株mef(A)阳性，37.5%的erm(B)阳性。本研究中实时PCR检测基因分型结果与传统PCR基因分型和耐药表型分析结果的相关性为100%。大环内酯类耐药在德国日益受到关注。这种用于检测大环内酯类耐药的高度灵敏且特异的PCR方法有可能提供足够快速的结果，以改善链球菌感染的抗生素治疗。
