大环内酯类耐药 A 组β溶血性链球菌咽菌株的遗传共性。

Genetic commonality of macrolide-resistant group A beta hemolytic streptococcus pharyngeal strains.

机构信息

Children's Mercy Hospitals and Clinics, University of Missouri-Kansas City School of Medicine, KC, MO, USA.

出版信息

Ann Clin Microbiol Antimicrob. 2009 Dec 1;8:33. doi: 10.1186/1476-0711-8-33.

DOI:10.1186/1476-0711-8-33

PMID:19951439

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2790432/

Abstract

BACKGROUND

Group A beta hemolytic streptococcus (GABHS) pharyngitis is a common childhood illness. Penicillin remains the gold standard therapy, but macrolides are indicated for the penicillin allergic patient, and are often used for convenience.

METHODS

We conducted a surveillance study of children with pharyngitis and positive streptococcal rapid antigen testing from 10/05 to 10/06 at 2 sites (A & B). Demographics, treatment, and resistance data was collected and compared to previous data from 2002. Erythromycin (EM) resistance was determined by disk diffusion and E-test on 500 isolates. Pulse field gel electrophoresis (PFGE) was performed to measure genetic relatedness of isolates. StatXact version 8 software (Cytel Inc., Cambridge, MA) was utilized to perform Fisher's exact test and exact confidence interval (CI) analysis.

RESULTS

There were no differences in resistance rates or demographic features, with the exception of race, between sites A & B. EM resistance was 0 in 2002, 3.5% in 2005-06 at site A, and 4.5% in 2005-06 at site B. 3/7 and 3/9 had inducible resistance at A and B respectively. 8 isolates had relatedness > or =80%, 5 of which were 88% homologous on PFGE.

CONCLUSION

Community macrolide resistance has increased following increased macrolide use. These results may have treatment implications if use continues to be high.

摘要

背景

A 组β溶血性链球菌（GABHS）咽炎是一种常见的儿童疾病。青霉素仍然是金标准治疗方法，但对于青霉素过敏的患者，大环内酯类药物是首选药物，并且由于方便而经常使用。

方法

我们在两个地点（A 和 B）进行了一项针对咽炎和链球菌快速抗原检测阳性的儿童的监测研究，时间为 10/05 至 10/06。收集了人口统计学、治疗和耐药数据，并与 2002 年的先前数据进行了比较。使用 500 个分离株通过圆盘扩散和 E 试验测定红霉素（EM）耐药性。脉冲场凝胶电泳（PFGE）用于测量分离株的遗传相关性。使用 StatXact 版本 8 软件（Cytel Inc.，马萨诸塞州剑桥）进行 Fisher 确切检验和确切置信区间（CI）分析。

结果

除了种族外，A 和 B 两个地点在耐药率或人口统计学特征方面没有差异。2002 年 EM 耐药率为 0%，2005-06 年 A 点耐药率为 3.5%，2005-06 年 B 点耐药率为 4.5%。A 和 B 分别有 3/7 和 3/9 具有诱导性耐药。8 个分离株具有相关性≥80%，其中 5 个在 PFGE 上具有 88%的同源性。