Medical Technology School, Xuzhou Medical University, Xuzhou 221004, China; Department of Laboratory Medicine, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221002, China.
Medical Technology School, Xuzhou Medical University, Xuzhou 221004, China.
Int J Infect Dis. 2017 Jun;59:44-49. doi: 10.1016/j.ijid.2017.03.023. Epub 2017 Apr 7.
To investigate fluoroquinolone resistance and associated mechanisms of Shigella sonnei isolates in Jiangsu Province of China between 2002 and 2011.
All 337 unduplicated S. sonnei isolates were collected from hospitals in Jiangsu Province from January 2002 to December 2011. Fluoroquinolone susceptibility was characterized by Kirby-Bauer disk diffusion method, and direct nucleotide sequencing of genes of the quinolone resistance determining regions were conducted. Also, the transferable quinolone resistance determinants, including qnrA, qnrB, qnrC, qnrD, qnrS, aac-(6')-Ib-cr and qepA were amplified by PCR.
Among 950 Shigella isolates, 337 (35.5%) were identified as S. sonnei, of which 76.6% displayed nalidixic acid resistance and norfloxacin-resistant isolates appeared in 2005-2009, with an average resistance rate of 21.8%. Commonly reported point mutations of Ser83Leu and Asp87Asn/Gly in gyrA and Ser80Ile in parC were detected, with mutation rates of 78.0%, 9.5% and 30.3%, respectively, while no alteration in gyrB or parE were detected. Besides, His211Tyr mutation in gyrA was first reported in a S. sonnei strain in 2009 and two novel mutations in parC were found, of which Met86Trp occurred in another strain in 2009 and Ser129Pro appeared every year except 2011 (28.8%). Plasmid-mediated quinolone resistance determinants were found in 23 isolates and 19 of these isolates were resistant to both nalidixic acid and norfloxacin. qnrB, qnrS, aac-(6')-Ib-cr and qepA were detected in 1, 7, 14 and 2 S. sonnei strains, relatively, and the most abundant PMQR gene found in this work was aac-(6')-Ib-cr (4.2%).
INTERPRETATION & CONCLUSIONS: S. sonnei became increasingly important as fluoroquinolone-resistant isolates emerged, and further detection on the resistant genes would be useful in the treatment and control of this infection.
本研究旨在调查 2002 年至 2011 年期间江苏省宋内志贺菌分离株的氟喹诺酮耐药情况及其相关机制。
2002 年 1 月至 2011 年 12 月,从江苏省各医院收集了 337 株未经重复的宋内志贺菌。采用 Kirby-Bauer 纸片扩散法测定氟喹诺酮药敏性,并对喹诺酮耐药决定区基因进行直接核苷酸测序。此外,通过 PCR 扩增可转移的喹诺酮耐药决定因子,包括 qnrA、qnrB、qnrC、qnrD、qnrS、aac-(6')-Ib-cr 和 qepA。
在 950 株志贺菌中,337 株(35.5%)鉴定为宋内志贺菌,其中 76.6%对萘啶酸耐药,2005-2009 年出现诺氟沙星耐药,耐药率平均为 21.8%。检测到 gyrA 中 Ser83Leu 和 Asp87Asn/Gly 以及 parC 中 Ser80Ile 的常见报道点突变,突变率分别为 78.0%、9.5%和 30.3%,而 gyrB 或 parE 未检测到改变。此外,2009 年首次在宋内志贺菌菌株中发现 gyrA 中 His211Tyr 突变,同时在 parC 中发现两个新的突变,其中 Met86Trp 发生在 2009 年的另一个菌株中,而 Ser129Pro 除 2011 年外每年均出现(28.8%)。在 23 株菌中发现了质粒介导的喹诺酮耐药决定因子,其中 19 株对萘啶酸和诺氟沙星均耐药。1、7、14 和 2 株宋内志贺菌分别检测到 qnrB、qnrS、aac-(6')-Ib-cr 和 qepA,本研究中发现的最丰富的 PMQR 基因是 aac-(6')-Ib-cr(4.2%)。
随着氟喹诺酮耐药分离株的出现,宋内志贺菌变得越来越重要,进一步检测耐药基因有助于治疗和控制这种感染。