重庆地区肺炎链球菌耐药性和分子流行病学调查

姚成; 余泽波; 肖永红

Abstract

姚成,余泽波,肖永红.重庆地区肺炎链球菌耐药性和分子流行病学调查[J].Chinese journal of Epidemiology,2005,26(6):431-434

重庆地区肺炎链球菌耐药性和分子流行病学调查

Study on drug resistance and molecular epidemiology of Streptococcus pneumoniae isolated in Chongqing

Received:July 19, 2004

DOI：

KeyWord: 肺炎链球菌耐药性流行病学分子

English Key Word: Streptococcus pneumoniae Antibiotic resistance Molecular epidemiology

FundProject:

Author Name	Affiliation
YAO Cheng	Department of Infectious Diseases, the First Affiliated Hospital, Chongqing University of Medical Sciences, Chongqing 400016, China
YU Ze-bo	Department of Infectious Diseases, the First Affiliated Hospital, Chongqing University of Medical Sciences, Chongqing 400016, China
XIAO Yong-hong	北京大学临床药理研究所

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Abstract:

目的调查重庆地区肺炎链球菌在社区获得性感染患者中的分离率及对抗生素的敏感性。方法采集社区获得性感染患者的痰、鼻咽拭子标本,培养、分离和鉴定肺炎链球菌。琼脂二倍稀释法测定肺炎链球菌对11种抗生素的耐药性。通过聚合酶链反应(PCR)扩增肺炎链球菌BOX重复元件对其进行分子流行病学分型。结果680份临床标本中,分离出39株肺炎链球菌,阳性率为5.7%。34株(有5株在保存过程中死亡)肺炎链球菌中有2株对青霉素低度耐药(MIC为0.125mg/L),1株青霉素敏感株对左氧氟沙星耐药(MIC为8mg/L)。肺炎链球菌对大环内酯类抗生素和克林霉素表现出较高的耐药率,且均为高度耐药(MIC≥64mg/L),对所测其他β内酰胺类和万古霉素均呈敏感。盒式PCR显示了较高的分辨率,能快速、可靠地检测菌株间的亲缘关系。35株肺炎链球菌共分为25个型,29个亚型,最多见的为A型图谱(3株),2株青霉素低度耐药株分属不同的型。结论重庆地区分离的临床肺炎链球菌对青霉素耐药率较低,但对大环内酯类抗生素和克林霉素耐药却非常普遍。盒式PCR能快速、可靠地对肺炎链球菌进行分子流行病学分型,重庆地区耐药克隆没有明显的优势株。

English Abstract:

Objective To investigate the prevalence and dr ug resistance o f Strep tococcus (S.) pneumoniae in pat ients infected in communities and molecular epidemiolo gy with BOX polymerase chain reaction(PCR) in Chongqing areas. Methods A total of 680 clinical specimens from sputum and t hroat/nasal swabs were collected from patients seen from September 2000 to March 2001. Antibiotic susceptibility was determined by agar dilution test. BOX PCR was used for molecular t yping of S. p neumoniae. Results A total of 39 isolates of S. p neumoniae were collected with the isolation rate of 5. 7%. Of the 34 S. p neumoniae strains, two show ed low level resistance to penicillin (MIC 0. 125 mg/L), one to levo floxacin, but many to macrolide and clindamycin (nearly 70%). All the strains were susceptible to lactams and vancomycin. BOX PCR typing demonstrated a hig h discriminatory potential and easy to be accurately analysed. 35 S. p neumoniae strains(include ATCC49619) were divided into 25 distinct types,representing 29 subty pes with A (n= 3) as t he predominant type. 2 penicillin resistant str ains were shown to be differ ent types. Conclusion Penicillin resistant rate of S. p neumoniae was low in Chong qing, but macrolide and clindamycin resistant str ains were common while BOX PCR typing was a suitable technique to type S. p neumoniae. No dominant antibiotic resistant strains were found in Chong qing.

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