Department of Microbiology and Molecular Biology, Universidade Federal do Rio Grande do Sul, Brazil.
Braz J Infect Dis. 2010 Nov-Dec;14(6):564-8. doi: 10.1016/s1413-8670(10)70113-6.
Resistance to macrolides, lincosamides and streptogramins B (MLS(B) antibiotics) in staphylococci may be due to modification in ribosomal target methylase encoded by erm genes. The expression of MLS(B) resistance lead to three phenotypes, namely constitutive resistance (cMLS(B)), inducible resistance (iMLS(B)), and resistance only to macrolides and streptogramins B (MS(B)). The iMLS(B) resistance is the most difficult to detect in the clinical laboratory.
This study investigated the expression of MLS(B) resistance and the prevalence of the erm genes among 152 clinical isolates of Staphylococcus aureus and coagulase-negative Staphylococcus (CNS) from Hospital de Clínicas de Porto Alegre.
Primary MLS(B) resistance was detected by the disk diffusion method. Isolates with iMLS(B) phenotype were tested by double-disk induction method. All isolates were tested by a genotypic assay, PCR with specific primers.
A total of 46.7% of staphylococci were positive for cMLS(B); 3.3% for iMLS(B) and 3.3% for MS(B). One or more erm genes were present in 50.1% of isolates. The gene ermA was detected in 49 isolates, ermC in 29 and ermB in 3.
The prevalence of the ermA, ermB and ermC genes were 29.6%, 17.1% and 0.66% respectively, and constitutive resistance was the most frequent as compared to the other two phenotypes.
葡萄球菌对大环内酯类、林可酰胺类和链阳菌素 B(MLS(B) 抗生素)的耐药性可能是由于 erm 基因编码的核糖体靶位甲基化酶的修饰所致。MLS(B) 耐药性的表达导致三种表型,即固有耐药(cMLS(B))、诱导耐药(iMLS(B))和仅对大环内酯类和链阳菌素 B(MS(B))耐药。iMLS(B) 耐药性是临床实验室最难检测到的。
本研究调查了来自 Porto Alegre 临床医院的 152 株金黄色葡萄球菌和凝固酶阴性葡萄球菌(CNS)临床分离株中 MLS(B) 耐药性的表达和 erm 基因的流行情况。
通过纸片扩散法检测原发性 MLS(B) 耐药性。具有 iMLS(B)表型的分离株通过双碟诱导法进行检测。所有分离株均通过基因分型检测、特异性引物 PCR 进行检测。
共有 46.7%的葡萄球菌对 cMLS(B)呈阳性;3.3%为 iMLS(B),3.3%为 MS(B)。50.1%的分离株存在一个或多个 erm 基因。在 49 株分离株中检测到 ermA,在 29 株分离株中检测到 ermC,在 3 株分离株中检测到 ermB。
ermA、ermB 和 ermC 基因的流行率分别为 29.6%、17.1%和 0.66%,与其他两种表型相比,固有耐药性最为常见。