Pires R, Rolo D, Gama-Norton L, Morais A, Lito L, Salgado M J, Johansson C, Möllerberg G, Henriques-Normark B, Gonçalo-Marques J, Santos-Sanches I
Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Monte de Caparica, Portugal.
Microb Drug Resist. 2005 Winter;11(4):360-70. doi: 10.1089/mdr.2005.11.360.
In this study, we analyzed the antimicrobial resistance properties and T antigenic types of 511 isolates collected in Lisbon district, Portugal, from throat swabs of healthy subjects (n=341), during 2000-2002 and from diverse infection sites (n=170) of outpatients and inpatients, during 1999-2002. Erythromycin resistance was higher in tonsillitis/pharyngitis (27.4%) and skin infection isolates (21.1%), than in carriage and invasive isolates (<or=10%). Differences in erythromycin resistance among children and adults were noticed only for carriage isolates (9.3% in children and 21.1% in adults). Most erythromycin-resistant isolates from carriage (82.4%) and tonsillitis/pharyngitis (71.9%) showed the M phenotype. All M phenotype isolates (n=53) carried mef(A), whereas all MLS(B) phenotype isolates (n=19) carried erm(B) and not erm(A). Resistance to tetracycline [mediated by tet(M) in most isolates] was <or=6% in tonsillitis/pharyngitis and carriage isolates, 36.8% in skin infection isolates, and 44.1% in invasive isolates. The M phenotype increased since 2000, linked to a decrease of tetracycline resistance, and was predominantly associated with T1 in 2000-2001 and T12 in 2002 among carriage isolates, and with T8/25/Imp19 through 2000-2002 among tonsillitis/pharyngitis isolates. The majority (53%) of the tetracycline-resistant invasive isolates were nontypable. All isolates were susceptible to penicillin and chloramphenicol. This study showed that tetracycline and macrolide resistance frequency and phenotypes differ among GAS from various origins and changed over time. Moreover, T typing suggested that most drug-resistant isolates causing oropharyngeal carriage are distinct from the majority of isolates causing noninvasive and invasive infection.
在本研究中，我们分析了2000 - 2002年期间从葡萄牙里斯本地区健康受试者（n = 341）的咽拭子以及1999 - 2002年期间门诊和住院患者不同感染部位（n = 170）收集的511株分离株的抗菌药物耐药特性和T抗原类型。扁桃体炎/咽炎（27.4%）和皮肤感染分离株（21.1%）中的红霉素耐药率高于携带和侵袭性分离株（≤10%）。仅在携带分离株中注意到儿童和成人之间红霉素耐药性的差异（儿童为9.3%，成人为21.1%）。大多数来自携带（82.4%）和扁桃体炎/咽炎（71.9%）的红霉素耐药分离株表现为M表型。所有M表型分离株（n = 53）携带mef(A)，而所有MLS(B)表型分离株（n = 19）携带erm(B)而非erm(A)。扁桃体炎/咽炎和携带分离株中对四环素的耐药性（大多数分离株由tet(M)介导）≤6%，皮肤感染分离株中为36.8%，侵袭性分离株中为44.1%。自2000年以来M表型增加，与四环素耐药性降低有关，在携带分离株中2000 - 2001年主要与T1相关，2002年与T12相关，在扁桃体炎/咽炎分离株中2000 - 2002年与T8/25/Imp19相关。大多数（53%）对四环素耐药的侵袭性分离株无法分型。所有分离株对青霉素和氯霉素敏感。本研究表明，不同来源的A组链球菌中四环素和大环内酯类耐药频率及表型存在差异且随时间变化。此外，T分型表明，大多数引起口咽部携带感染的耐药分离株与大多数引起非侵袭性和侵袭性感染的分离株不同。
