1997 - 2012年中国儿童急性呼吸道感染中14型肺炎链球菌种群动态
Dynamics of serotype 14 Streptococcus pneumoniae population causing acute respiratory infections among children in China (1997-2012).
作者信息
He Mingming, Yao Kaihu, Shi Wei, Gao Wei, Yuan Lin, Yu Sangjie, Yang Yonghong
机构信息
Key Laboratory of Major Diseases in Children and National Key Discipline of Pediatrics, Ministry of Education, Beijing Pediatric Research Institute, Beijing Children's Hospital Affiliated to Capital Medical University, Beijing, P. R. China.
出版信息
BMC Infect Dis. 2015 Jul 11;15:266. doi: 10.1186/s12879-015-1008-7.
BACKGROUND
In the last decade, the Streptococcus pneumoniae population has changed, mainly due to the abuse of antibiotics. The aim of this study was to determine the genetic structure of 144 S. pneumonia serotype 14 isolates collected from children with acute respiratory infections during 1997-2012 in China.
METHODS
All isolated pneumococci were tested for their sensitivity to 11 kinds of antibiotics with the E-test method or disc diffusion. The macrolides resistance genes ermB and mefA, as well as the sulfamethoxazole-trimethoprim resistance gene dihydrofolate reductase (DHFR) were detected by polymerase chain reaction (PCR). The sequence types (STs) were analyzed with multilocus sequence typing (MLST).
RESULTS
From 1997 to 2012, the percentage of serotype 14 S. pneumonia isolates in the whole isolates increased. All of the 144 serotype 14 S. pneumonia isolates were susceptible to amoxicillin-clavulanic acid, vancomycin and levofloxacin. No penicillin resistant isolate was found, and the intermediate rate was as low as 0.7 %. Erythromycin resistance was confirmed among 143 isolates. The ermB gene was determined in all erythromycin resistant isolates, and the mefA gene was positive additionally in 13 of them. The non-susceptibility rate to the tested cephalosporins increased from 1997-2012. All trimethoprim-resistant isolates contained the Ile100-Leu mutation. Overall, 30 STs were identified, among which ST876 was the most prevalent, followed by ST875. During the study period, the percentage of CC876 increased from 0 % in 1997-2000 to 96.4 % in 2010-2012, whereas CC875 decreased from 84.2 to 0 %. CC876 showed higher non-susceptibility rates to β-lactam antibiotics than CC875.
CONCLUSION
The percentage of serotype 14 S. pneumonia isolates increased over time in China. The increase of resistance to β-lactam antibiotics in this serotype isolates was associated with the spread of CC876.
背景
在过去十年中，肺炎链球菌群体发生了变化，主要是由于抗生素的滥用。本研究的目的是确定1997年至2012年期间在中国从急性呼吸道感染儿童中分离出的144株14型肺炎链球菌的基因结构。
方法
所有分离出的肺炎球菌用E-test法或纸片扩散法检测对11种抗生素的敏感性。通过聚合酶链反应（PCR）检测大环内酯类耐药基因ermB和mefA，以及磺胺甲恶唑-甲氧苄啶耐药基因二氢叶酸还原酶（DHFR）。用多位点序列分型（MLST）分析序列类型（STs）。
结果
1997年至2012年，14型肺炎链球菌分离株在全部分离株中的百分比增加。144株14型肺炎链球菌分离株对阿莫西林-克拉维酸、万古霉素和左氧氟沙星均敏感。未发现对青霉素耐药的分离株，中介率低至0.7%。143株分离株证实对红霉素耐药。所有对红霉素耐药的分离株均检测到ermB基因，其中13株还检测到mefA基因阳性。1997年至2012年，对所检测头孢菌素的不敏感率增加。所有对甲氧苄啶耐药的分离株均含有Ile100-Leu突变。总体而言，共鉴定出30种STs，其中ST876最为常见，其次是ST875。在研究期间，CC876的百分比从1997年至2000年的0%增加到2010年至2012年的96.4%，而CC875从84.2%下降到0%。CC876对β-内酰胺类抗生素的不敏感率高于CC875。
结论
在中国，14型肺炎链球菌分离株的百分比随时间增加。该血清型分离株对β-内酰胺类抗生素耐药性的增加与CC876的传播有关。
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