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山东大学学报（医学版） ›› 2015, Vol. 53 ›› Issue (1): 77-80.doi: 10.6040/j.issn.1671-7554.0.2014.679

• 公共卫生与管理学 • 上一篇    下一篇

2013年山东省四地市儿童A群链球菌耐药特征及其表型、基因型分析

刘贞艳1, 胡彬2, 毕振旺2, 寇增强2, 房明2, 陈保立2, 任艳艳2, 毕振强1,3   

  1. 1. 山东大学公共卫生学院流行病与卫生统计学系, 山东 济南 250012;
    2. 山东省疾病预防控制中心细菌性传染病防治所, 山东 济南 250014;
    3. 山东省疾病预防控制中心 山东省传染病预防控制重点实验室 山东大学预防医学研究院, 山东 济南 250014
  • 收稿日期:2014-10-09 修回日期:2014-11-25 发布日期:2015-01-10
  • 通讯作者: 毕振强。E-mail:bzq63@163.com E-mail:bzq63@163.com
  • 基金资助:
    国家科技重大专项(2012ZX10004215)

Antibiotic resistance on group A streptococcus among children in 4 cities of Shandong Province in 2013

LIU Zhenyan1, HU Bin2, BI Zhenwang2, KOU Zengqiang2, FANG Ming2, CHEN Baoli2, REN Yanyan2, BI Zhenqiang1,3   

  1. 1. Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan 250012, Shandong, China;
    2. Institute for Bacterial Infectious Disease Prevention and Control, Shandong Center for Disease Control and Prevention, Jinan 250014, Shandong, China;
    3. Shandong Center for Disease Control and Prevention, Shandong Key Laboratory of Infectious Disease Prevention and Control, Shandong University Institute of Preventive Medicine, Jinan 250014, Shandong, China
  • Received:2014-10-09 Revised:2014-11-25 Published:2015-01-10

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摘要： 目的 了解2013年山东省四地市A群链球菌(GAS)耐药特征及其耐药表型和基因型,为临床治疗GAS感染提供依据。方法 从济南、青岛、淄博、潍坊四地市的猩红热、无症状GAS携带者咽拭子中分离获得72株GAS,采用K-B纸片扩散法检测青霉素、红霉素、克林霉素、左氧氟沙星、四环素、氯霉素、万古霉素、头孢噻肟8种抗生素的耐药情况;提取DNA,PCR扩增ermA、ermB、mefA、tetM、tetO共5种耐药基因,毛细管电泳检测基因阳性率;利用D-抑菌圈试验确定耐药表型。结果 72株GAS中,青霉素、左氧氟沙星、氯霉素、万古霉素、头孢噻肟敏感率均为100%,红霉素、克林霉素、四环素耐药率为100%、100%、94.44%。共检出ermB、tetM两种耐药基因,其阳性率均为100%,未检出ermA、mefA、tetO。仅检出一种耐药表型:固有型耐药表型(cMLS)检出率100%,未发现诱导型耐药表型(iMLS)和主动外排型耐药表型(M)。结论 2013年山东省GAS菌株中,耐药模式以红霉素-克林霉素-四环素共同耐药为主,耐药表型以cMLS为主,耐药基因型以ermB、tetM共同携带为主。

关键词: 耐药基因, 山东省, 儿童, 链球菌,酿脓, 耐药, 药敏试验

Abstract: Objective To investigate the characteristics of antibiotic resistance, resistance phenotypes and genotypes on group A streptococcus (GAS) isolated from children in 4 cities of Shandong Province in 2013 and to provide reference for clinical treatment of GAS infection. Methods A total of 72 strains of GAS were isolated from throat swabs of children with scarlet fever or asymptomatic carriers. The resistance of GAS strains on 8 antibiotics, including penicillin, erythromycin, clindamycin, levofloxacin, tetracycline, chloramphenicol, vancomycin and cefotaxime, were measured with K-B disk-diffusion method. DNA was extracted from GAS strains, resistance genes (ermA, ermB, mefA, tetM, tetO) were amplified with PCR method, then positive rates of genes were assessed with capillary electrophoresis. Theresistance phenotypes were detected with text. Results Among the 72 strains of GAS, all isolates were susceptible to penicillin, levofloxacin, chloramphenicol, vancomycin and cefotaxime. The resistance rates of erythromycin, clindamycin and tetracycline were 100%, 100% and 94.44%, respectively. Two resistance genes, ermB and tetM, were detected (both 100%), while ermA, mefA and tetO were not. Only cMLS phenotype was found in all isolates (100%), while iMLS and M phenotype were not (0%). Conclusion The resistance pattern of GAS in 4 cities of Shandong Province in 2013 was multiple antibiotic resistance of erythromycin-clindamycin-tetracycline. The resistance phenotype was cMLS, and the genotypes were mainly co-carried ermB and tetM.

Key words: Resistance genes, Children, Drug resistance, Bacterial susceptibility testing, Streptococcus pyogenes, Shandong Province

中图分类号: 

  • R446.5
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