论文部分内容阅读
目的了解苏州地区儿童肺炎链球菌(SP)青霉素、红霉素、四环素和万古霉素耐药基因的流行状况。方法从2002年9月至2003年4月苏州大学附属儿童医院就诊呼吸道感染患儿痰标本中分离SP;对分离到的31株菌进行4种抗生素药敏试验和pbp2B、ermA/B、mefA、tetM、vanA、vanB等7种基因的聚合酶链反应(PCR)检测;将pbp2BPCR产物进行测序,并与SPR6株(青霉素敏感株,登录号:NC003098)pbp2B序列比较。结果31株菌中:(1)青霉素敏感株38.7%(n=12),不敏感株61.3%(n=19),pbp2B基因突变株64.5%(n=20);(2)红霉素敏感株9.7%(n=3),耐药株80.6%(n=25),中介株9.7%(n=3),红霉素不敏感率90.3%,检出ermA/B基因71%(n=22),mefA基因32.1%(n=10),ermA/B和/或mefA基因87.1%(n=27);(3)四环素敏感株9.7%(n=3),耐药株80.6%(n=25),中介株9.7%(n=3),四环素不敏感率90.3%,检出tetM基因株90.3%(n=28);(4)万古霉素敏感株100%(n=31),不敏感率0%,31株菌均未检出vanA、vanB基因。结论苏州地区的SP临床分离株对青霉素、红霉素、四环素具多重高耐药性,对万古霉素具高敏感性之特征。青霉素、红霉素、四环素的耐药相关基因检测提供了该菌耐药的遗传学证据。
Objective To understand the prevalence of penicillin, erythromycin, tetracycline and vancomycin resistance genes in children with Streptococcus pneumoniae (SP) in Suzhou area. Methods SP was isolated from sputum samples from children with respiratory tract infection in Children’s Hospital Affiliated to Soochow University from September 2002 to April 2003. Four antibiotics susceptibility tests and pbp2B, ermA / B, mefA, tetM, vanA and vanB. The pbp2BPCR product was sequenced and compared with the pbp2B sequence of SPR6 strain (penicillin sensitive strain, accession number NC003098). Results 31 strains were: (1) 38.7% (n = 12) of penicillin sensitive strains, 61.3% (n = 19) of insensitive strains and 64.5% (n = 20) of mutated pbp2B genes; (N = 3), resistant strains 80.6% (n = 25), intermediate strains 9.7% (n = 3), erythromycin insensitivity rate 90.3%, detection of ermA / B gene 71% (N = 22), meiA gene 32.1% (n = 10), ermA / B and / or mefA gene 87.1% (n = 27) (N = 28); (4) vancomycin sensitive strains were 100% (n = 31), and the tetracycline insensitivity rate was 90.3% Insensitivity rate of 0%, 31 strains were not detected vanA, vanB gene. Conclusion SP clinical isolates in Suzhou area are highly resistant to penicillin, erythromycin and tetracycline, and have high sensitivity to vancomycin. Penicillin, erythromycin, tetracycline resistance-related gene testing provides proof of genetic resistance to the bacteria.