【摘要】 目的调查上海地区肺炎链球菌对红霉素的敏感度,研究肺炎链球菌对大环内酯类抗生素耐药机制。方法对中山医院57株临床分离肺炎链球菌进行红霉素药敏试验;应用聚合酶链反应(PCR)技术对上海4所医院中分离的53株红霉素耐药肺炎链球菌检测耐药基因(ermB,mefA,mefE)。结果57株肺炎链球菌中12株(21.0%)敏感,3株(5.3%)中介,42株(73.7%)耐药。53株红霉素耐药肺炎链球菌中,ermB基因、mefE基因、mefA基因分别在51株(96.2%)、22株(41.5%)和1株(1.9%)中检测到。其中21株(39.6%)同时检测到ermB基因和mefE基因,1株(1.9%)同时检测到ermB基因和mefA基因,1株(1.9%)未检测到ermB基因、mefE基因或mefA基因。结论上海地区肺炎链球菌对大环内酯类抗生素耐药率较高。ErmB介导的靶位改变是最常见的耐药机制,mef(特别是mefE)介导外排机制引起者也较常见。更多还原

【Abstract】 Objective To investigate the prevalence and genotypic characterization of erythromycin-resistant Streptococcus pneumoniae in Shanghai,China.Methods Fifty-seven strains of S.pneumoniae from Zhongshan Hospital were collected to evaluate the prevalence of antibiotic resistance and 53 strains of erythromycin-resistant S.pneumoniae from 4 hospitals in Shanghai were examined by PCR for the presence of macrolide resistance genes(ermB,mefA and mefE).Results Of the 57 isolates,12(21%) were susceptible,3(5.3%) intermediate,and 42(73.7%) resistant to erythromycin.Of the 53 isolates,51(96.2%) were positive for ermB gene,22(41.5%) positive for mefE,and 1(1.9%) positive for mefA gene in PCR study.Both mefE and ermB genes were detected from 21(39.6%) isolates,both mefA and ermB genes were detected in 1 isolate.One isolate had none of mefA,mefE or ermB gene.Conclusions Erythromycin resistance in S.pneumoniae is a serious problem in Shanghai,China.Target alteration induced by ermB is the most common mechanism of erythromycin resistance and mef,especially mefE,is also common in S.pneumoniae isolates from Shanghai.更多还原