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目的对武汉市分离自12~18月龄健康婴幼儿鼻咽部的75株肺炎链球菌(Streptococcus pneumoniae,Spn),进行耐药检测及多位点序列分型(muhilocus sequence typing,MLST),了解该市Spn耐药菌株遗传背景。方法用E-test方法检测菌株对8种抗菌药物的耐药情况,并对多重耐药株进行MLST分型。结果左氧氟沙星(LVX)、莫西沙星(MFX)、头孢曲松(CRO)、青霉素(PEN)及阿莫西林/克拉维酸(AMX)对该组Spn细菌有良好的体外活性,敏感率分别为100.00%,100.00%,88.00%,92.00%,89.30%。此组Spn对阿奇霉素(AZM)和红霉素(ERY)的耐药率很高,分别为90.67%,90.67%。对头孢呋辛(CXM)的耐药率为24.00%。75菌株中24株为多重耐药,以CXM/AZM/ERY多重耐药模式为主。MLST分型表明,ST3173(6)、ST271(4)、ST876(4)、ST3397(3)为多重耐药菌株常见型别。研究得到的12个ST型别中,有4个型别ST271(4)、ST320(2)、ST90(1)、ST1661(1),共8菌株,属于国际流行耐药克隆株克隆株(Pneumococcal molecular Epidemiology Network,PMEN)Taiwan~(19F)-14及Spain~(6B)-2。多重耐药菌株中一株属于新的型别ST6318,与研究中其它ST型存在两个以上等位基因差别。结论武汉市健康婴幼儿Spn分离株中,国际PMEN克隆株的传播对耐药性的增加发挥了重要作用。同时,抗性基因水平转移也促进了耐药性的改变。
Objective To detect 75 strains of Streptococcus pneumoniae (Spn) isolated from the nasopharynx of healthy infants from 12 to 18 months old in Wuhan for drug resistance test and multi-locus sequence typing (MLST) The city Spn resistant strains genetic background. Methods E-test was used to detect the resistance of the strains to 8 kinds of antibacterials, and MLST was performed on the multi-resistant strains. Results The levofloxacin (LVX), moxifloxacin (MFX), ceftriaxone (CRO), penicillin (PEN) and amoxicillin / clavulanic acid (AMX) had good activity against Spn bacteria in this group. The sensitivity rates were 100.00%, 100.00%, 88.00%, 92.00%, 89.30%. The resistance rates of Spn to azithromycin (AZM) and erythromycin (ERY) in this group were high, which were 90.67% and 90.67%, respectively. The resistance rate to cefuroxime (CXM) was 24.00%. Among the 75 strains, 24 strains were multi-drug resistant, with CXM / AZM / ERY multi-drug resistance model as the main. MLST typing showed that ST3173 (6), ST271 (4), ST876 (4) and ST3397 (3) were common types of multidrug resistant strains. Among the 12 ST types, 4 strains were ST271 (4), ST320 (2), ST90 (1), ST1661 (1) and 8 strains, belonging to the pneumococcal family Molecular Epidemiology Network, PMEN) Taiwan ~ (19F) -14 and Spain ~ (6B) -2. One strain of multidrug-resistant strains belonged to the new type ST6318, which differed from two or more alleles in other ST types in the study. CONCLUSIONS: The spread of international PMEN clones in healthy infants Spn isolates in Wuhan plays an important role in the increase of drug resistance. At the same time, horizontal resistance gene transfer also promoted the change of drug resistance.