【摘要】 目的了解广州地区对红霉素耐药的肺炎链球菌中ermB及mefE基因的分布,比较ermB基因与mefE基因对红霉素耐药的肺炎链球菌的耐药性。方法2001—2004于广州市儿童医院用克林霉素纸片法检测239株对红霉素耐药的肺炎链球菌,并用浓度梯度法检测其耐药性。结果239株对红霉素耐药的肺炎链球菌中,ermB、mefE基因介导的耐药率分别为70·3%(168/239)和29·7%(71/239)。168株ermB基因介导对红霉素耐药的肺炎链球菌,对青霉素(MIC500·19μg/mL、MIC901·5μg/mL)、阿莫西林/克拉维酸(MIC500·19μg/mL、MIC901·0μg/mL)、头孢曲松(MIC500·19μg/mL、MIC900·75μg/mL)、头孢呋辛(MIC500·38μg/mL、MIC902·0μg/mL)、头孢克洛(MIC502·0μg/mL、MIC9032·0μg/mL)的不敏感率分别为58·4%、1·2%、20·8%、46·5%和51·7%。71株mefE基因介导对红霉素耐药的肺炎链球菌,对青霉素(MIC500·5μg/mL、MIC901·5μg/mL)、阿莫西林/克拉维酸(MIC500·38μg/mL、MIC901·0μg/mL)、头孢曲松(MIC500·38μg/mL、MIC900·75μg/mL)、头孢呋辛(MIC501·0μg/mL、MIC903·0μg/mL)、头孢克洛(MIC506·0μg/mL、MIC9048·0μg/mL)的不敏感率分别为67·6%、0、19·7%、59·2%和61·9%。结论广州地区对红霉素耐药的肺炎链球菌其耐药机制以ermB基因介导为主;ermB基因介导的红霉素耐药性高于mefE基因介导的耐药性;ermB和mefE基因介导对红霉素耐药的肺炎链球菌对β-内酰胺类药物存在不同程度的耐药。更多还原

【Abstract】 Objective To investigate the mechanisms of erythromycin-resistant streptococcus pnenoniae and their variable antimicrobial resistance.Methods Clindamycin disks were to screen erythromycin-resistant streptococcus pneumoniae mediated by ermB ro mefE genes.Antimicrobial resistance of erythromycin-resistant streptococcus pneumoniae mediated by ermB of mefE genes were studied by Etest respectively.Results ErmB and mefE genes were 70.3%(168/239) and 29.7%(71/239) respectively among 239 strains of erythromycin-resistant streptococcus pneumoniae.The rates of resistance to penicillin (MIC_ 50 0.19μg/mL,MIC_ 90 1.5μg/mL),amoxicillin/clavulanic acid (MIC_ 50 0.19μg/mL,MIC_ 90 1.0μg/mL),ceftrixone (MIC_ 50 0.19μg/mL,MIC_ 90 0.75μg/mL),cefuroxime (MIC_ 50 0.38μg/mL,MIC_ 90 2.0μg/mL),cefaclor (MIC_ 50 2.0μg/mL,MIC_ 90 32.0μg/mL) of erythromycin-resistant streptococcus pneumoniae mediated by ermB were 58.4%,1.2%,20.8%,46.5% and 51.7% respectively,and the resistance rates to penicillin(MIC_ 50 0.5μg/mL,MIC_ 90 1.5μg/mL),amoxicillin/clavulanic acid (MIC_ 50 0.38μg/mL,MIC_ 90 1.0μg/mL),ceftrixone (MIC_ 50 0.38μg/mL,MIC_ 90 0.75μg/mL),cefuroxime (MIC_ 50 1.0μg/mL,MIC_ 90 3.0μg/mL),cefaclor (MIC_ 50 6.0μg/mL,MIC_ 90 48.0μg/mL) of erythromycin-resistant streptococcus pneumoniae mediated by mefE were 67.6%,0,19.7%,59.2% and 61.9% respectively (including decreased susceptibility).Conclusion Erythromycin-resistant streptococcus pneumoniae mediated by ermB is predominant in Guangzhou,the level of erythromycin resistance mediated by ermB is usually higher due to mefE.Erythromycin-resistant streptococcus pneumoniae mediated by ermB or mefE genes also has β-lactam resistance in various level.更多还原