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来自加纳健康学龄前儿童的多重耐药肺炎链球菌分离株

Multidrug-Resistant Streptococcus pneumoniae Isolates from Healthy Ghanaian Preschool Children.

作者信息

Dayie Nicholas T K D, Arhin Reuben E, Newman Mercy J, Dalsgaard Anders, Bisgaard Magne, Frimodt-Møller Niels, Slotved Hans-Christian

机构信息

1 Department of Medical Microbiology, University of Ghana Medical School , Accra, Ghana .

2 Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark .

出版信息

Microb Drug Resist. 2015 Dec;21(6):636-42. doi: 10.1089/mdr.2014.0314. Epub 2015 Jul 14.

Abstract

Streptococcus pneumoniae is the cause of high mortality among children worldwide. Antimicrobial treatment and vaccination are used to control pneumococcal infections. In Ghana, data on antimicrobial resistance and the prevalence of multidrug-resistant pneumococcal clones are scarce; hence, the aim of this study was to determine the antibiogram of S. pneumoniae recovered from Ghanaian children younger than six years of age and to what extent resistances were due to the spread of certain sero- and multilocus sequence typing (MLST) types. The susceptibility of 115 pneumococcal isolates, recovered in a previous study, to six antimicrobials was determined by disk diffusion test. Overall, 90.4% of isolates were intermediate penicillin resistant, 99.1% were trimethoprim resistant, 73.0% were tetracycline resistant, and 33.9% were sulfamethoxazole resistant. Low resistance was recorded for erythromycin (2.6%) and cefotaxime (5.2%). Overall, 72.2% of isolates were resistant to penicillin (I or R) and at least two other antimicrobials. MLST of 20 isolates showing resistance to at least four antimicrobials revealed a high diversity documented by 16 different clones, none of which had previously been associated with multidrug resistance. The resistances found may have emerged due to nonprudent antimicrobial use practices and there is a need to monitor and promote prudent antimicrobial usage in Ghana.

摘要

肺炎链球菌是全球儿童高死亡率的病因。抗菌治疗和疫苗接种被用于控制肺炎球菌感染。在加纳,关于抗菌药物耐药性和多重耐药肺炎球菌克隆流行情况的数据匮乏;因此,本研究的目的是确定从加纳6岁以下儿童分离出的肺炎链球菌的抗菌谱,以及耐药性在多大程度上归因于某些血清型和多位点序列分型(MLST)型别的传播。通过纸片扩散试验测定了在先前一项研究中分离出的115株肺炎球菌对六种抗菌药物的敏感性。总体而言,90.4%的分离株对青霉素中介耐药,99.1%对甲氧苄啶耐药,73.0%对四环素耐药,33.9%对磺胺甲恶唑耐药。红霉素(2.6%)和头孢噻肟(5.2%)的耐药率较低。总体而言,72.2%的分离株对青霉素(中介或耐药)以及至少两种其他抗菌药物耐药。对至少四种抗菌药物耐药的20株分离株的MLST显示出高度多样性,有16个不同的克隆记录在案,其中没有一个先前与多重耐药相关。所发现的耐药性可能是由于不谨慎的抗菌药物使用习惯所致,加纳有必要监测并推广谨慎使用抗菌药物。

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