中国儿童侵袭性疾病中红霉素耐药肺炎链球菌分离株的特征。

Characterization of erythromycin-resistant Streptococcus pneumoniae isolates causing invasive diseases in Chinese children.

机构信息

Key Laboratory of Major Diseases in Children and the National Key Discipline of Pediatrics (Capital Medical University), Ministry of Education, Beijing Pediatrics Research Institute, Beijing Children's Hospital, Beijing 10045, China.

出版信息

Chin Med J (Engl). 2013;126(8):1522-7.

PMID:23595388

Abstract

BACKGROUND

Erythromycin-resistant Streptococcus pneumoniae isolates that causing invasive pneumococcal diseases (IPD) in Chinese children remain uncharacterized. This study aims to identify the resistance genes associated with erythromycin resistance and to determine the genetic relationships of IPD isolates in Chinese children.

METHODS

A total of 171 S. pneumoniae strains were isolated from 11 medical centers in China from 2006 to 2008. All the isolates were characterized via serotyping and antibiotic susceptibility determination. The erythromycin-resistant isolates were further characterized via ermB and mefA gene detection, multi-locus sequence typing analysis, and pulsed-field gel electrophoresis.

RESULTS

A total of 164 (95.9%) isolates showed resistance to erythromycin, of which 162 strains with high high-level resistance (MIC ≥ 256 µg/ml). A total of 104 (63.4%) isolates carry the ermB gene alone, whereas 59 (36.0%) harbor both ermB and mefA genes. Of the 59 strains, 54 were of serotypes 19A and 19F and were identified as highly clonal and related to the Taiwan(19F)-14 clone.

CONCLUSIONS

The erythromycin resistance rate in IPD isolates is significantly high and is predominantly mediated by the ermB gene. Isolates that carry both ermB and mefA genes are predominantly of serotypes 19A and 19F.

摘要

背景

导致中国儿童侵袭性肺炎球菌病（IPD）的耐红霉素肺炎链球菌分离株尚未得到充分描述。本研究旨在鉴定与红霉素耐药相关的耐药基因，并确定中国儿童 IPD 分离株的遗传关系。

方法

2006 年至 2008 年，从中国 11 家医疗中心共分离出 171 株肺炎链球菌。所有分离株均通过血清分型和抗生素敏感性测定进行鉴定。通过 ermB 和 mefA 基因检测、多位点序列分型分析和脉冲场凝胶电泳进一步鉴定红霉素耐药分离株。

结果

共 164 株（95.9%）对红霉素表现出耐药性，其中 162 株具有高高水平耐药（MIC≥256μg/ml）。共 104 株（63.4%）携带 ermB 基因，而 59 株（36.0%）携带 ermB 和 mefA 基因。在 59 株中，54 株为 19A 和 19F 血清型，高度克隆，与台湾（19F）-14 克隆有关。