在肺炎链球菌肺炎的普那霉素治疗期间，核糖体蛋白L22发生突变，出现了一株对链阳菌素耐药的肺炎链球菌分离株。
Emergence of a Streptococcus pneumoniae isolate resistant to streptogramins by mutation in ribosomal protein L22 during pristinamycin therapy of pneumococcal pneumonia.
作者信息
Cattoir Vincent, Merabet Lilia, Legrand Patrick, Soussy Claude-James, Leclercq Roland
机构信息
Laboratoire de Bactériologie-Virologie-Hygiène, CHU Henri Mondor, Assistance Publique-Hôpitaux de Paris, Université Paris XII, Créteil, France.
出版信息
J Antimicrob Chemother. 2007 May;59(5):1010-2. doi: 10.1093/jac/dkm041. Epub 2007 Apr 13.
OBJECTIVES
The aim of this study was to characterize the mechanism of resistance to macrolides and streptogramins of a Streptococcus pneumoniae strain isolated from blood cultures in an 80-year-old patient suffering from severe pneumonia unsuccessfully treated with pristinamycin.
METHODS
Resistance genes erm(B) and mef(A) were searched for by PCR. Portions of genes for domains V and II of the 23S rRNA (rrl) and genes for ribosomal proteins L4 (rplD) and L22 (rplV) were amplified by PCR from total genomic DNA and sequenced.
RESULTS
Resistance genes erm(B) and mef(A) were not detected. Only mutation in the rplV gene encoding ribosomal protein L22 was detected. The strain contained a six amino acid insertion ((107)KRTAHI(108)) in the C-terminus of the ribosomal protein L22.
CONCLUSIONS
This is the first report of emergence of a pneumococcus resistant to streptogramins by mutation in ribosomal protein L22 during treatment with pristinamycin.
目的
本研究旨在阐明从一名80岁严重肺炎患者血培养中分离出的肺炎链球菌菌株对大环内酯类和链阳性菌素耐药的机制，该患者使用利奈唑胺治疗无效。
方法
通过PCR检测耐药基因erm(B)和mef(A)。从总基因组DNA中通过PCR扩增23S rRNA（rrl）的结构域V和II的部分基因以及核糖体蛋白L4（rplD）和L22（rplV）的基因，并进行测序。
结果
未检测到耐药基因erm(B)和mef(A)。仅检测到编码核糖体蛋白L22的rplV基因发生突变。该菌株在核糖体蛋白L22的C末端含有六个氨基酸插入（(107)KRTAHI(108)）。
结论
这是首例关于在用利奈唑胺治疗期间核糖体蛋白L22发生突变导致肺炎链球菌对链阳性菌素耐药的报道。
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