Department of Molecular Microbiology, National Medicines Institute, Warsaw, Poland.
Antimicrob Agents Chemother. 2010 May;54(5):1720-7. doi: 10.1128/AAC.01340-09. Epub 2010 Mar 1.
In this study, we analyzed 118 penicillin-nonsusceptible Streptococcus pneumoniae (PNSP) isolates (MICs, >or=0.12 microg/ml) recovered in Poland in 2003 to 2005 from patients with respiratory tract diseases and invasive infections. Seven different serotypes (14, 9V, 23F, 19F, 6B, 19A, and 6A, in order of descending frequency), seven alleles of the murM gene (murMA, murMB6, and the new murMB12 to -16 alleles), and 31 multilocus sequence types (STs) were observed. The vast majority of the PNSP isolates (90.7%) belonged to the international multiresistant clones, and among these, the Spain(9V)-ST156 clonal complex was the most prevalent (56 isolates) and was significantly overrepresented in invasive infections. The clone has been evolving rapidly, as demonstrated by the observed number of STs, the diversity in multiple-locus variable-number-tandem-repeat analysis (MLVA) types, and the polymorphism of pbp and pspA genes (coding for penicillin-binding proteins and the pneumococcal surface protein A, respectively). The presence and structure of the rlrA islet (encoding the pneumococcal pilus) were very well conserved. The Spain(9V)-ST156 clonal complex has been largely responsible for a decreasing susceptibility to penicillin among pneumococci in Poland in recent years, in spite of a relatively moderate antimicrobial use.
在这项研究中，我们分析了 2003 年至 2005 年期间从波兰患有呼吸道疾病和侵袭性感染的患者中分离出的 118 株青霉素不敏感肺炎链球菌（PNSP）（MIC ＞或= 0.12 微克/毫升）。观察到 7 种不同血清型（14、9V、23F、19F、6B、19A 和 6A，按频率降序排列）、7 种 murM 基因等位基因（murMA、murMB6 和新的 murMB12 至 -16 等位基因）和 31 种多位点序列型（ST）。绝大多数 PNSP 分离株（90.7%）属于国际多耐药克隆，其中西班牙（9V）-ST156 克隆复合体最为流行（56 株），在侵袭性感染中显著过表达。该克隆正在迅速进化，这一点可以从观察到的 ST 数量、多位点可变数串联重复分析（MLVA）类型的多样性以及 pbp 和 pspA 基因的多态性（分别编码青霉素结合蛋白和肺炎球菌表面蛋白 A）得到证明。rlrA 岛（编码肺炎球菌菌毛）的存在和结构得到了很好的保守。尽管抗菌药物的使用相对适度，但近年来，西班牙（9V）-ST156 克隆复合体在波兰导致肺炎球菌对青霉素的敏感性下降。
