苏州地区儿童肺炎链球菌临床分离株4种抗生素的耐药基因分子流行病学研究

丁云芳; 糜祖煌; 张建华; 陶云珍; 秦玲

Abstract

丁云芳,糜祖煌,张建华,陶云珍,秦玲.苏州地区儿童肺炎链球菌临床分离株4种抗生素的耐药基因分子流行病学研究[J].Chinese journal of Epidemiology,2005,26(6):435-439

苏州地区儿童肺炎链球菌临床分离株4种抗生素的耐药基因分子流行病学研究

Study on the molecule epidemiological between resistances of 7 genes interrelated 4 antibiotic to isolated

Received:June 14, 2004

DOI：

KeyWord: 肺炎链球菌耐药基因流行病学，分子

English Key Word: Streptococcus pneumoniae Antibiotic resistance gene Epidemiology molecule

FundProject:

Author Name	Affiliation
DING Yun-fang	The Affiliated Children’s Hospital of Suzhou University, Suzhou 215003, China
MI Zu-huang	无锡市克隆遗传技术研究所
ZHANG Jian-hua	The Affiliated Children’s Hospital of Suzhou University, Suzhou 215003, China
TAO Yun-zhen	The Affiliated Children’s Hospital of Suzhou University, Suzhou 215003, China
QIN Ling	无锡市克隆遗传技术研究所

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Abstract:

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。

English Abstract:

Objective To investigate the molecule epidemic for 7 genes interrelated penicillin,erythromycin,tetracycline, vancomycin resistance of isolated S t reptococcus pneumoniae (SP) in children at Suzhou area. Methods (1) Thirty2one pneumococcal isolates were collected from respiratory tract secretions of children with respiratory diseases from Nov 2002 to Apr 2003 at the Children’s Hospital of Suzhou University (reference strain ATCC49619). (2) Penicillin susceptibility was determined by E2test,while erythromycin, tetracycline, vancomycin were determined by K2B disk. (3) The detecting of pbp2 B,ermA/B, mef A, tetM, vanA, vanB genes by PCR, Sequencing pbp2 B genes, Contrasting pbp2 BDNA sequences among pneumococcal isolates and SP R6 [penicillin sensitive (www. ncbi. nlm. gov/nucleotide, NC2003098)]. Results Of thirty2one isolates studied,the results were shown as follows;(1)Penicillin sensibility 38. 7%(n=12), penicillin resistance 61. 3%(n=19), pbp2 B mutation 64. 5%(n =20);(2) Erythromycin sensibility 9. 7%(n=3),erythromycin resistance 90. 3%(n=28), ermA/B 71%(n=22), mef A 32. 1%(n=10), ermA/B + mef A 87. 1%(n=27);(3) Tetracycline sensibility 9. 7%(n=3),tetracycline resistance 90. 3%(n=28), tetM 90. 3%(n=28);(4) Vancomycin sensibility 100%(n=31), vanA, vanB all 0%. Conclusion Among pneumococcal isolates at our area, penicillin,erythromycin,tetracycline resistance were high,vancomycin was sensitive. Detecting 7 genes interrelated penicillin,erythromycin,tetracycline,vancomycin resistance expressed genotypies for antibiotic resistances in pneumococcal isolates.

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