Jain Amita, Shukla Vivek Kumar, Tiwari Vandana, Kumar Rashmi
Department of Microbiology, CSM Medical University, Lucknow, UP, India.
Indian J Med Sci. 2008 Oct;62(10):392-6.
The current resistance pattern of GABHS (group-A beta-hemolytic streptococci) in India has not been discussed.
To fill the above-mentioned void, we planned this study to determine the prevalence and degree of antibacterial resistance in GABHS isolates.
Children with acute pharyngo-tonsillitis who had not received antibiotic in the preceding week, attending the pediatric OPD, were prospectively enrolled over a period of 1 year. Throat swabs were collected from each child and transported to microbiology laboratory, as early as possible.
A throat swab culture for GABHS was done. All GABHS were subjected to antibiotic susceptibility and minimum inhibitory concentration (MIC) test according to Clinical Laboratory Standard Institute (CLSI) guidelines.
In the present study, 12.6% (55/435) of the children with acute pharyngo-tonsillitis had throat swab culture positive for GABHS. The prevalence of macrolide resistance was 10.2%. The MIC50 for macrolide-resistant strain was 0.5 microg/mL (range, 0.125-8 microg/mL), and MIC90 was 8 microg/mL (range, 0.125-8 microg/mL). Tetracycline and co-trimoxazole resistances were 24.5% and 12.2% respectively. The values of MIC50 for tetracycline- and co-trimoxazole-resistant strains were 4 microg/mL (range, 0.125-32 microg/mL) and 2 microg/mL (range, 0.25-8 microg/mL) respectively. All isolates were sensitive to penicillin G and chloramphenicol on disc diffusion test. However, their MIC50 was 0.032 microg/mL (range, 0.012-0.125 microg/mL) and 2 microg/mL (range, 0.25-4 microg/mL) respectively.
High prevalence of antimicrobial resistance found among GABHS needs a longitudinal surveillance of isolates from different centers in India.
印度A组β溶血性链球菌(GABHS)目前的耐药模式尚未得到探讨。
为填补上述空白,我们开展了本研究以确定GABHS分离株的抗菌药物耐药率及耐药程度。
前瞻性纳入1年间在儿科门诊就诊、前一周未使用过抗生素的急性咽扁桃体炎患儿。从每个患儿采集咽拭子,并尽早送至微生物实验室。
进行GABHS咽拭子培养。所有GABHS分离株均按照临床实验室标准协会(CLSI)指南进行抗生素敏感性和最低抑菌浓度(MIC)检测。
在本研究中,12.6%(55/435)的急性咽扁桃体炎患儿咽拭子培养GABHS呈阳性。大环内酯类耐药率为10.2%。大环内酯类耐药菌株的MIC50为0.5μg/mL(范围:0.125 - 8μg/mL),MIC90为8μg/mL(范围:0.125 - 8μg/mL)。四环素和复方新诺明耐药率分别为24.5%和12.2%。四环素和复方新诺明耐药菌株的MIC50值分别为4μg/mL(范围:0.125 - 32μg/mL)和2μg/mL(范围:0.25 - 8μg/mL)。在纸片扩散试验中,所有分离株对青霉素G和氯霉素敏感。然而,它们的MIC50分别为0.032μg/mL(范围:0.012 - 0.125μg/mL)和2μg/mL(范围:0.25 - 4μg/mL)。
GABHS中发现的高抗菌药物耐药率需要对印度不同中心的分离株进行长期监测。