Medical Microbiology Department, Medical Faculty, Adnan Menderes University, Aydın 09010, Turkey.
J Infect Chemother. 2011 Oct;17(5):658-64. doi: 10.1007/s10156-011-0238-x. Epub 2011 Apr 2.
Macrolide resistance mechanisms in 89 Streptococcus pneumoniae strains isolated from several clinical samples between February 2007 and May 2009 were investigated. Erythromycin resistance was noted in 35 (40%) S. pneumoniae strains. In these strains, the most frequent resistance phenotype was cMLS(B) (74%), and the most frequent resistance genotype was ermB (82%). Both ermB and mefA genes were positive in 20% of macrolide-resistant strains. While no resistance to vancomycin, linezolid and telithromycin was noted in 89 S. pneumoniae strains, 12 (13%) strains were penicillin resistant, 26 (30%) strains were clindamycin resistant, 35 (40%) were azithromycin resistant, 32 (36%) strains were tetracycline resistant, and 1 (1%) strain was levofloxacin resistant. The serotype distribution of 35 macrolide-resistant S. pneumoniae strains revealed that the most frequent serotype was serogroup 19 (45%). Multidrug resistance was present in 19 (86%) of 22 strains carrying only the ermB resistance gene. No clonal dissemination was noted in the macrolide-resistant pneumococcal strains. These findings suggest that macrolide resistance rates, resistance phenotype and genotype, as well as resistant serotypes of S. pneumoniae strains should be continuously monitored in our country.
2007 年 2 月至 2009 年 5 月间，从若干临床标本中分离出 89 株肺炎链球菌，对其大环内酯类耐药机制进行了研究。35 株（40%）肺炎链球菌对红霉素耐药。这些菌株中最常见的耐药表型为 cMLS(B)（74%），最常见的耐药基因型为 ermB（82%）。20%的大环内酯类耐药菌株中 ermB 和 mefA 基因均为阳性。89 株肺炎链球菌对万古霉素、利奈唑胺和泰利霉素均无耐药性，但 12 株（13%）对青霉素耐药，26 株（30%）对克林霉素耐药，35 株（40%）对阿奇霉素耐药，32 株（36%）对四环素耐药，1 株（1%）对左氧氟沙星耐药。35 株大环内酯类耐药肺炎链球菌的血清型分布显示，最常见的血清型为 19 组（45%）。仅携带 ermB 耐药基因的 22 株菌中，19 株（86%）存在多药耐药。未发现大环内酯类耐药肺炎链球菌存在克隆传播。这些发现提示，应在我国持续监测肺炎链球菌的大环内酯类耐药率、耐药表型和基因型以及耐药血清型。
