Korona-Glowniak Izabela, Maj Maciej, Siwiec Radosław, Niedzielski Artur, Malm Anna
Department of Pharmaceutical Microbiology with Laboratory for Microbiological Diagnostics, Medical University of Lublin, Lublin, Poland.
Department of Clinical Immunology, Medical University of Lublin, Lublin, Poland.
PLoS One. 2016 Jul 14;11(7):e0158909. doi: 10.1371/journal.pone.0158909. eCollection 2016.
A total of 125 isolates were recovered from adenoids and/or nasopharynx of 170 children aged 2 to 5 from south-east Poland; they had undergone adenoidectomy for recurrent and/or persistent symptoms of upper respiratory tract infections. Pneumococcal isolates were analyzed by phenotyping (serotyping and antimicrobial resistance tests) and genotyping together with the clonality of the pneumococcal isolates based on resistance determinants, transposon distribution and multilocus sequence typing (MLST). Serotypes 19F, 6B and 23F constituted 44.8% of the isolates. Among all of the strains, 44.8% showed decreased susceptibility to penicillin and resistance to co-trimoxazole (52.8%), tetracycline (38.4%), erythromycin (53.6%), clindamycin (52.8%) and chloramphenicol (27.2%) was observed. Tn6002 was found in 34.8% of erythromycin-resistant isolates while composite Tn2010-in 16.7% of erm(B)-carrying isolates that harboured also mef(E) gene. Tn3872-related elements were detected in 27.3% of erythromycin-resistant strains. In the majority of chloramphenicol-resistant catpC194-carrying isolates (79.4%), ICESp23FST81-family elements were detected. The genotyping showed that pneumococcal population was very heterogeneous; 82 sequence types (STs) were identified, and the most frequent contributed to not more than 8% of the isolates. Nearly 44% STs were novel, each of them was recovered only from one child. Four STs belonged to one of the 43 worldwide spread resistant pneumococcal clones currently accepted by Pneumococcal Molecular Epidemiology Network (PMEN), i.e. Spain 9V-3, Spain 23F-1, Norway NT-42 and Poland 6B-20, accounting for 12 (16.7%) of the 75 nonususceptible isolates, and five STs were single-locus variants of PMEN resistant clones (England 14-9, Spain 9V-3, Spain 23F-1, Greece 21-30, Denmark 14-32), accounting 9 (12%) of nonsusceptible isolates. A few MDR clones belonging to 6B and 19F serotypes found among preschool children emphasizes rather the role of clonal dissemination of local strains in the community than international clones spreading in the increase of resistance among pneumococcal strains.
从波兰东南部170名2至5岁儿童的腺样体和/或鼻咽部共分离出125株菌株；这些儿童因反复和/或持续的上呼吸道感染症状接受了腺样体切除术。通过表型分析（血清分型和抗菌药物耐药性测试）以及基因分型，结合基于耐药决定因素、转座子分布和多位点序列分型（MLST）的肺炎球菌分离株的克隆性，对肺炎球菌分离株进行了分析。血清型19F、6B和23F占分离株的44.8%。在所有菌株中，44.8%对青霉素敏感性降低，对复方新诺明（52.8%）、四环素（38.4%）、红霉素（53.6%）、克林霉素（52.8%）和氯霉素（27.2%）耐药。在34.8%的红霉素耐药分离株中发现了Tn6002，而在16.7%携带erm(B)基因且也携带mef(E)基因的分离株中发现了复合Tn2010。在27.3%的红霉素耐药菌株中检测到与Tn3872相关的元件。在大多数携带catpC194的氯霉素耐药分离株（79.4%）中检测到ICESp23FST81家族元件。基因分型显示肺炎球菌群体非常异质；鉴定出82种序列类型（STs），最常见的STs占分离株的比例不超过8%。近44%的STs是新的，每种仅从一名儿童中分离得到。四种STs属于肺炎球菌分子流行病学网络（PMEN）目前认可的43种全球传播的耐药肺炎球菌克隆之一，即西班牙9V-3、西班牙23F-1、挪威NT-42和波兰6B-20，占75株非敏感分离株中的12株（16.7%），五种STs是PMEN耐药克隆的单一位点变体（英格兰14-9、西班牙9V-3、西班牙23F-1、希腊21-30、丹麦14-32），占非敏感分离株的9株（12%）。在学龄前儿童中发现的一些属于6B和19F血清型的多重耐药克隆强调了社区中本地菌株的克隆传播作用，而非国际克隆在肺炎球菌菌株耐药性增加中的传播作用。
