Wan Mahmud Wan Norliyana, Hassan Siti Asma', Abd Rahman Zaidah, Wan Abdul Wahab Wan Nor Amilah, Ismail Nabilah
Hospital Kemaman, Terengganu, Malaysia.
Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
Malays J Med Sci. 2024 Apr;31(2):188-198. doi: 10.21315/mjms2024.31.2.17. Epub 2024 Apr 23.
is one of the leading causes of mortality and morbidity worldwide. The dramatic increase in in-vitro resistance of antimicrobial agents, particularly beta-lactams and macrolides, makes pneumococcal infections difficult to treat. The aim of this study was to describe the drug resistance rate, assess the prevalence of macrolide-resistant genes and review the clinical complications of pneumococcal infections among patients presented to Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia.
This is a descriptive cross-sectional study. All isolates collected from clinical specimens within a 1-year period were subjected to selected antimicrobial susceptibility testing using E-test strips. Polymerase chain reaction (PCR) analysis was conducted to detect macrolide-resistant determinants. The patient's clinical data were obtained from clinical notes.
A total of 113 patients with a positive growth of were included in the study. The most common predisposing factors among them were bronchopulmonary diseases (15.9%). The penicillin-resistant rate was 7.1%, with minimal inhibitory concentration (MIC) ranging between 0.012 μg/mL and >32 μg/mL, and the erythromycin-resistant rate was 26.5%, with a MIC range of 0.03 μg/mL-> 256 μg/mL. Most of the erythromycin-resistant isolates were found to have the (A) gene (50.4%) and the (B) gene (20%); 16.7% had a combination of genes (A) and (B), and 13.3% had none of the two genes. Community-acquired pneumonia is the predominant type of pneumococcal infection. There was no significant association between the presence of macrolide resistance determinants and mortality ( = 0.837) or complications ( > 0.999 for empyema and cardiac complication; = 0.135 for subdural abscess).
The majority of erythromycin-resistant isolates were found to have the (A) gene, followed by the (B) gene and a combination of genes (A) and (B).
是全球死亡和发病的主要原因之一。抗菌药物，尤其是β-内酰胺类和大环内酯类药物的体外耐药性急剧增加，使得肺炎球菌感染难以治疗。本研究的目的是描述马来西亚吉兰丹州马来西亚理科大学医院（HUSM）患者中肺炎球菌感染的耐药率，评估大环内酯类耐药基因的流行情况，并回顾其临床并发症。
这是一项描述性横断面研究。在1年期间从临床标本中收集的所有分离株均使用E-test试纸条进行选定的抗菌药物敏感性测试。进行聚合酶链反应（PCR）分析以检测大环内酯类耐药决定因素。患者的临床数据从临床记录中获得。
共有113例肺炎球菌生长阳性的患者纳入研究。其中最常见的易感因素是支气管肺部疾病（15.9%）。青霉素耐药率为7.1%，最低抑菌浓度（MIC）范围在0.012μg/mL至>32μg/mL之间，红霉素耐药率为26.5%，MIC范围为0.03μg/mL->256μg/mL。大多数红霉素耐药分离株被发现具有（A）基因（50.4%）和（B）基因（20%）；16.7%具有基因（A）和（B）的组合，13.3%两者均无。社区获得性肺炎是肺炎球菌感染的主要类型。大环内酯类耐药决定因素的存在与死亡率（=0.837）或并发症（脓胸和心脏并发症>0.999；硬膜下脓肿=0.135）之间无显著关联。
大多数红霉素耐药分离株被发现具有（A）基因，其次是（B）基因以及基因（A）和（B）的组合。
