哥伦比亚医院革兰氏阳性球菌大环内酯类耐药性特征：一项全国性监测
Characterization of macrolide resistance in Gram-positive cocci from Colombian hospitals: a countrywide surveillance.
作者信息
Reyes Jinnethe, Hidalgo Marylin, Díaz Lorena, Rincón Sandra, Moreno Jaime, Vanegas Natasha, Castañeda Elizabeth, Arias César A
机构信息
Bacterial Molecular Genetics Unit, Centro de Investigaciones, Universidad El Bosque, Bogotá, Colombia.
出版信息
Int J Infect Dis. 2007 Jul;11(4):329-36. doi: 10.1016/j.ijid.2006.09.005. Epub 2007 Feb 21.
OBJECTIVE
The characterization of macrolide resistance in Gram-positive cocci recovered from Colombian hospitals.
METHODS
The resistance profiles and mechanism of macrolide resistance were investigated in isolates of Streptococcus pneumoniae (1679), Staphylococcus aureus (348), coagulase-negative staphylococci (CoNS) (175), and Enterococcus spp (123). Minimum inhibitory concentrations (MICs) for erythromycin (ERY) and clindamycin (CLI), detection of macrolide resistance genes, phenotypic characterization, and pulsed field gel electrophoresis (PFGE) of macrolide-resistant pneumococci were performed.
RESULTS
Resistance to ERY and CLI was 3.3% and 2.3% for S. pneumoniae, 58% and 57% for S. aureus (94% for both compounds in methicillin-resistant Staphylococcus aureus (MRSA)), and 78.6% and 60.7% in methicillin-resistant Staphylococcus epidermidis, respectively. ERY resistance was 62% in Enterococcus faecalis and 82% in Enterococcus faecium. The MLS(B)-type accounted for 71% of S. pneumoniae and 100% of MRSA. The erm(A) gene was prevalent in MRSA, erm(B) in S. pneumoniae and enterococci, and erm(C) in CoNS isolates. Efflux pump genes (mef(A) genes) were mostly identified in S. pneumoniae (24%). The most common genotype amongst ERY-resistant pneumococci was the Spain(6B)-2 clone.
CONCLUSIONS
The prevalence of macrolide resistance is low in Colombian pneumococci and high in MRSA (cMLS(B)-type).
目的
对从哥伦比亚医院分离出的革兰氏阳性球菌中的大环内酯类耐药性进行特征分析。
方法
对肺炎链球菌（1679株）、金黄色葡萄球菌（348株）、凝固酶阴性葡萄球菌（CoNS，175株）和肠球菌属（123株）的分离株进行耐药谱及大环内酯类耐药机制研究。测定了红霉素（ERY）和克林霉素（CLI） 的最低抑菌浓度（MIC），检测大环内酯类耐药基因，进行表型特征分析以及对耐大环内酯类肺炎链球菌进行脉冲场凝胶电泳（PFGE）分析。
结果
肺炎链球菌对ERY和CLI的耐药率分别为3.3%和2.3%，金黄色葡萄球菌分别为58%和57%（耐甲氧西林金黄色葡萄球菌（MRSA）对两种化合物的耐药率均为94%），耐甲氧西林表皮葡萄球菌分别为78.6%和60.7%。粪肠球菌对ERY的耐药率为62%，屎肠球菌为82%。MLS（B）型占肺炎链球菌的71%，占MRSA的100%。erm（A）基因在MRSA中普遍存在，erm（B）在肺炎链球菌和肠球菌中普遍存在，erm（C）在CoNS分离株中普遍存在。外排泵基因（mef（A）基因）大多在肺炎链球菌中被鉴定出来（24%）。耐ERY肺炎链球菌中最常见的基因型是Spain(6B)-2克隆。
结论
哥伦比亚肺炎链球菌中大环内酯类耐药的流行率较低，而MRSA中较高（cMLS（B）型）。
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