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[临床分离的耐青霉素肺炎链球菌中青霉素结合蛋白2B基因的出现情况]

[Occurrences of penicillin-binding protein 2B gene in clinically isolated penicillin-resistant Streptococcus pneumoniae].

作者信息

Chen G, Fukuchi K, Wakuta R, Sando T, Takagi Y, Gomi K

机构信息

Department of Clinical Pathology, Showa University, School of Medicine.

出版信息

Rinsho Byori. 1998 Sep;46(9):948-53.

PMID:9800482
Abstract

We analyzed 88 strains of Streptococcus pneumoniae (S. pneumoniae) isolated in Showa University Hospital from June 1995 to July 1996. The ratios of antibiotic resistance were 39% to penicillin G, 50% to erythromycin, and 2% to imipenem. No resistant to cefotaxime and ofloxacin was observed. Thirty-four strains (39%) were considered to be penicillin-resistant S. pneumoniae (PRSP) strains (MIC of penicillin G > or = 0.5 microgram/ml), according to the breakpoint determined by the Japanese Working Group for Penicillin-Resistant Streptococcus pneumoniae. The ratio of PRSP was higher in S. pneumoniae isolated from inpatients (25/47) when compared to that from outpatients. By PCR analysis, DNA regions of autolysin were amplified in all the 88 strains, confirming that the isolates were S. pneumoniae. Penicillin-binding protein 2B (PBP2B) class B region was positive in 32 strains, and PBP2B class A was in 2 strains. Twenty eight of 34 strains of PRSP contained the PBP2B class B gene. In the remaining six PRSP strains, neither the PBP2B class A nor B region was amplified. The PBP2B class B region was detected as a 180-kb fragment of SmaI digestion of S. pneumoniae DNA by Southern blot analysis, confirming that the detection of PBP2B class B gene by PCR is reliable. We concluded that the PBP2B class B gene is considered to be a major gene responsible for phenotypic resistance of PRSP. We performed genotyping by SmaI digestion pattern using pulsed field gel electrophoresis. No identical pattern was observed in isolates from inpatients, suggesting that apparent nosocomial infection of S. pneumoniae was negligible.

摘要

我们分析了1995年6月至1996年7月在昭和大学医院分离出的88株肺炎链球菌。抗生素耐药率分别为:对青霉素G耐药率39%,对红霉素耐药率50%,对亚胺培南耐药率2%。未观察到对头孢噻肟和氧氟沙星耐药的菌株。根据日本耐青霉素肺炎链球菌工作组确定的断点,34株(39%)被认为是耐青霉素肺炎链球菌(PRSP)菌株(青霉素G的最低抑菌浓度≥0.5微克/毫升)。与门诊患者分离的肺炎链球菌相比,住院患者分离的肺炎链球菌中PRSP的比例更高(25/47)。通过PCR分析,在所有88株菌株中均扩增出自溶素的DNA区域,证实分离株为肺炎链球菌。32株菌株的青霉素结合蛋白2B(PBP2B)B类区域呈阳性,2株菌株的PBP2B A类区域呈阳性。34株PRSP菌株中有28株含有PBP2B B类基因。在其余6株PRSP菌株中,PBP2B A类和B类区域均未扩增。通过Southern印迹分析,PBP2B B类区域被检测为肺炎链球菌DNA经SmaI酶切后的180 kb片段,证实通过PCR检测PBP2B B类基因是可靠的。我们得出结论,PBP2B B类基因被认为是PRSP表型耐药的主要基因。我们使用脉冲场凝胶电泳通过SmaI酶切模式进行基因分型。在住院患者的分离株中未观察到相同的模式,这表明肺炎链球菌明显的医院感染可忽略不计。

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