DiPersio Linda P, DiPersio Joseph R, Beach Jacqueline A, DeFine Linda A
Falor Division of Surgical Research, Summa Health System, Akron, OH 44304, USA.
Diagn Microbiol Infect Dis. 2006 Aug;55(4):327-31. doi: 10.1016/j.diagmicrobio.2006.01.030. Epub 2006 Apr 19.
The emergence of macrolide- and lincosamide-resistant Streptococcus pneumoniae is a worldwide concern. Of particular interest is the increasing prevalence of erythromycin and clindamycin-resistant isolates containing both erm(B) and mef genes. This study determined the prevalence of erythromycin and clindamycin resistance in 596 clinical S. pneumoniae isolates from 2 adult tertiary care hospitals over a 4-year period (2001-2004). Erythromycin resistance increased from 24% to 34%, but S. pneumoniae isolates resistant to clindamycin as well as to erythromycin increased from 3% in 2001 to 15.5% in 2004 (5-fold increase). Among erythromycin-resistant isolates, those also resistant to clindamycin (MLS(B) phenotype) increased 3-fold (12.8-45%). Of forty-one erythromycin/clindamycin-resistant S. pneumoniae isolates tested, 29 (71%) contained both erm(B) and mef(E) genes. Pulsed-field gel electrophoresis performed on 28 erm(B) + mef(E) positive isolates identified 2 predominant and possibly related clones, which made up 64% of the isolates.
对大环内酯类和林可酰胺类耐药的肺炎链球菌的出现是一个全球性的问题。特别值得关注的是，同时携带erm(B)和mef基因的对红霉素和克林霉素耐药的分离株的患病率不断上升。本研究确定了在4年期间（2001 - 2004年）从2家成人三级护理医院分离出的596株临床肺炎链球菌中红霉素和克林霉素耐药的患病率。红霉素耐药率从24%上升到34%，但对克林霉素和红霉素均耐药的肺炎链球菌分离株从2001年的3%增加到2004年的15.5%（增加了5倍）。在红霉素耐药分离株中，对克林霉素也耐药的分离株（MLS(B)表型）增加了3倍（从12.8%增至45%）。在检测的41株对红霉素/克林霉素耐药的肺炎链球菌分离株中，29株（71%）同时含有erm(B)和mef(E)基因。对28株erm(B) + mef(E)阳性分离株进行的脉冲场凝胶电泳鉴定出2个主要的且可能相关的克隆，它们占分离株的64%。
