Hashida Koichi, Shiomori Teruo, Hohchi Nobusuke, Ohkubo Jun-ichi, Ohbuchi Toyoaki, Mori Takanori, Suzuki Hideaki
Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
Int J Pediatr Otorhinolaryngol. 2011 May;75(5):664-9. doi: 10.1016/j.ijporl.2011.02.005. Epub 2011 Mar 2.
We conducted a prospective bacteriological survey to investigate antibiotic resistance-related genetic characteristics and the turnover of nasopharyngeal Streptococcus pneumoniae carriage in healthy children in day-care centers (DCCs).
A total of 363 nasopharyngeal mucus samples were collected from children aged 0 to 6 years attending two DCCs in the summer of 2004 (n=181) and the following winter (n=182). We obtained 157 S. pneumoniae isolates and analyzed them by antibiotic susceptibility testing, PCR assay for the penicillin-binding protein (PBP) genes and macrolide-resistance gene, and pulsed-field gel electrophoresis (PFGE).
The overall carriage rate was 43.3% (157/363). The percentages of penicillin-intermediately resistant S. pneumoniae (PISP) strains, penicillin-resistant S. pneumoniae (PRSP) strains, erythromycin-intermediately resistant S. pneumoniae strains and erythromycin-resistant S. pneumoniae strains were 35.7% (56/157), 0.6% (1/157), 1.9% (3/157), and 69.4% (109/157), respectively. The percentages of S. pneumoniae strains with the pbp mutation(s) and mefA and/or ermB gene(s) were 92.4% (145/157) and 71.3% (112/157), respectively. Fifty strains with different PFGE patterns were obtained from among the 157 isolates. Thirteen strains were observed in both seasons, but only one of these strains was isolated from the same carrier. Twenty-one strains (42.0%) were isolated from two or more children, and 17 of these were each isolated from children attending the same DCC.
These results indicate the spread of S. pneumoniae, particularly those with antibiotic-resistance genes, and the vigorous genetic turnover and substantial horizontal transmission of this pathogen in healthy children attending DCCs in Japan.
我们进行了一项前瞻性细菌学调查，以研究日托中心（DCCs）健康儿童中与抗生素耐药相关的遗传特征以及鼻咽部肺炎链球菌携带情况的变化。
2004年夏季（n = 181）和次年冬季（n = 182），从两所DCCs中0至6岁的儿童中总共采集了363份鼻咽部黏液样本。我们获得了157株肺炎链球菌分离株，并通过抗生素敏感性测试、青霉素结合蛋白（PBP）基因和大环内酯耐药基因的PCR检测以及脉冲场凝胶电泳（PFGE）对其进行分析。
总体携带率为43.3%（157/363）。青霉素中介耐药肺炎链球菌（PISP）菌株、青霉素耐药肺炎链球菌（PRSP）菌株、红霉素中介耐药肺炎链球菌菌株和红霉素耐药肺炎链球菌菌株的比例分别为35.7%（56/157）、0.6%（1/157）、1.9%（3/157）和69.4%（109/157）。携带pbp突变和mefA和/或ermB基因的肺炎链球菌菌株比例分别为92.4%（145/157）和71.3%（112/157）。从157株分离株中获得了50种不同PFGE模式的菌株。在两个季节均观察到13株菌株，但其中只有1株是从同一携带者分离得到的。21株菌株（42.0%）是从两个或更多儿童中分离得到的，其中17株是从就读于同一DCC的儿童中分别分离得到的。
这些结果表明肺炎链球菌，特别是那些携带抗生素耐药基因的菌株在日本日托中心的健康儿童中传播，并且该病原体存在活跃的基因变化和大量的水平传播。
