您的位置：山东大学 -> 科技期刊社 -> 《山东大学学报（医学版）》

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

PDF (PC)

92

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
[1] Ralph AP, Carapetis JR. Group A streptococcal diseases and their global burden[J]. Curr Top Microbiol Immunol, 2013, 368: 1-27. doi: 10.1007/82_2012_280.
[2] Uchil RR, Kohli GS, Katekhaye VM, et al. Strategies to combat antimicrobial resistance[J]. J Clin Diagn Res, 2014, 8(7):ME01-04.
[3] 柯碧霞, 李柏生, 谭海玲, 等. 广东省猩红热患儿酿脓链球菌病原学特征分析[J]. 中华微生物学和免疫学杂志, 2013, 33(5): 360-363. KE Bixia, LI Baisheng, TAN Hailing, et al. Etiological characteristics of Streptococcus pyogenes isolated from children with Scarlet fever in Guangdong province, China[J]. Chinese Journal of Microbiology and Immunology, 2013, 33(5): 360-363.
[4] Friães A, Pinto FR, Silva-Costa C, et al. Group A streptococci clones associated with invasive infections and pharyngitis in Portugal present differences in emm types, superantigen gene content and antimicrobial resistance[J]. BMC Microbiol, 2012, 12:280. doi: 10.1186/1471-2180-12-280.
[5] Torres RS, Torres RP, Smeesters PR, et al. Group A streptococcus antibiotic resistance in southern Brazil: a 17-year surveillance study[J]. Microb Drug Resist, 2011, 17(2): 313-319.
[6] Rubio-López V, Valdezate S, Alvarez D, et al. Molecular epidemiology, antimicrobial susceptibilities and resistance mechanisms of Streptococcus pyogenes isolates resistant to erythromycin and tetracycline in Spain (1994-2006)[J]. BMC Microbiol, 2012,12: 215. doi: 10.1186/1471-2180-12-215.
[7] Villaseñor-Sierra A, Katahira E, Jaramillo-Valdivia AN, et al. Phenotypes and genotypes of erythromycin-resistant Streptococcus pyogenes strains isolated from invasive and non-invasive infections from Mexico and the USA during 1999-2010[J]. Int J Infect Dis, 2012, 16(3): e178-181.
[8] 刘爽, 李静, 彭晓旻, 等. 北京市儿童A组链球菌分离株耐药特征及相关因素研究[J]. 中华流行病学杂志, 2012, 33(11): 1133-1138. LIU Shuang, LI Jing, PENG Xiaomin, et al. Characteristics and related factors related to the resistance on antibiotics among group A streptococcus strains isolated from children in Beijing, during May and July 2011[J]. Chinese Journal of Epidemiology, 2012, 33(11): 1133-1138.
[9] 姚开虎. 关注国内儿科A族链球菌的分型和耐药状况[J]. 中国实用儿科杂志, 2012, 27(4): 262-264. YAO Kaihu. Concerned about the emm types and drug resistance of group A Streptococcus in China[J]. Chinese Journal of Practical Pediatrics, 2012, 27(4): 262-264.
[10] Capoor MR, Nair D, Deb M, et al. Resistance to erythromycin and rising penicillin MIC in Streptococcus pyogenes in India[J]. Jpn J Infect Dis, 2006, 59(5): 334-336.
[11] Chang H, Shen X, Fu Z, et al. Antibiotic resistance and molecular analysis of Streptococcus pyogenes isolated from healthy schoolchildren in China[J]. Scand J Infect Dis, 2010, 42(2): 84-89.
[12] d'Humières C, Cohen R, Levy C, et al. Decline in macrolide-resistant Streptococcus pyogenes isolates from French children[J]. Int J Med Microbiol, 2012, 302(7-8): 300-303.
[13] Koh E, Kim S. Decline in erythromycin resistance in Group A streptococci from acute pharyngitis due to changes in the emm genotypes rather than restriction of antibiotic use[J]. Korean J Lab Med, 2010, 30(5): 485-490.
[14] Rodríguez C, Rojas P, Wozniak A, et al. Resistance phenotypes and genotypes of Streptococcus pyogenes clinical isolates in Chile over a 10-year period[J]. Rev Med Chil. 2011, 139(9): 1143-1149.
[15] Liu X, Shen X, Chang H, et al. High macrolide resistance in Streptococcus pyogenes strains isolated from children with pharyngitis in China[J]. Pediatr Pulmonol, 2009, 44(5): 436-441.
[16] Wang HB, Song YY, You YH, et al. Molecular epidemiological analysis of Group A Streptococci isolated from children in Chaoyang District of Beijing, 2011: emm types, virulence factor genes and erythromycin resistant genes[J]. Biomed Environ Sci, 2013, 26(9): 782-784.
[17] Brenciani A, Bacciaglia A, Vecchi M, et al. Genetic elements carrying erm(B) in Streptococcus pyogenes and association with tet(M) tetracycline resistance gene[J]. Antimicrob Agents Chemother, 2007, 51(4): 1209-1216.
[18] Huang CY, Lai JF, Huang IW, et al. Epidemiology and molecular characterization of macrolide-resistant Streptococcus pyogenes in Taiwan[J]. J Clin Microbiol, 2014, 52(2): 508-516.
[19] Brenciani A, Ojo KK, Monachetti A, et al. Distribution and molecular analysis of mef(A)-containing elements in tetracycline-susceptible and -resistant Streptococcus pyogenes clinical isolates with efflux-mediated erythromycin resistance[J]. J Antimicrob Chemother, 2004, 54(6): 991-998.
[1] 葛丽娟 金瑞峰 王纪文 许新升 李癊. 多药耐药基因1 C1236T多态性与癫痫患者对药物反应性的相关性[J]. 山东大学学报(医学版), 2209, 47(6): 99-102.
[2] 董伟,邢乃栋,吕家驹,刘帅,孙亮,曹庆伟,董宇昊,刘钊,丁森泰. 靶向抑制有丝分裂驱动蛋白治疗多西紫杉醇耐药前列腺癌的体外疗效[J]. 山东大学学报（医学版）, 2017, 55(9): 23-30.
[3] 朱建雷,刘金同,王旸,王端卫,朱晓萌,张珊静,朱建伟. 枣庄市农村留守儿童主观生活质量与自我意识现状[J]. 山东大学学报（医学版）, 2017, 55(9): 128-132.
[4] 徐加龙,孙小刚,王军锋,刘倩,马楠,李殿国,陈维秀,李金良,王若义. 经腹腔镜手术与开放手术治疗原发性膀胱憩室临床效果比较[J]. 山东大学学报（医学版）, 2017, 55(7): 95-99.
[5] 王美建,侯新国,梁凯,陈丽. 山东省城市中老年人群血脂现状调查[J]. 山东大学学报（医学版）, 2017, 55(5): 70-75.
[6] 李安, 陈丰哲,王正,孟祥珠,许楠楠,马立宪. 西他沙星、头孢哌酮/舒巴坦和多黏菌素E单药及联合用药对泛耐药鲍曼不动杆菌的抗菌活性[J]. 山东大学学报（医学版）, 2017, 55(4): 82-85.
[7] 孟伟,吴大玮,单悌超,张帆,郭海鹏,刘宇,丁士芳,翟茜. 替加环素治疗重症患者呼吸机相关性肺炎[J]. 山东大学学报（医学版）, 2017, 55(4): 71-75.
[8] 陈吴康,吕翠霞,张晓菲,董蕾,杜以慧,傅继华. 女性性工作者吸食冰毒情况及其影响因素分析[J]. 山东大学学报（医学版）, 2016, 54(9): 73-76.
[9] 袁源,司珩,刘宏伟,刘春华,王哲,阮玉华,邢辉. 不同时期抗病毒治疗对艾滋病患者耐药产生的影响分析[J]. 山东大学学报（医学版）, 2016, 54(9): 77-81.
[10] 李燕,刘坤,孙晓杰. 山东省3县农村老年人与收入相关的健康不平等状况及影响因素[J]. 山东大学学报（医学版）, 2016, 54(6): 91-96.
[11] 赵云霞,宋静,张灿灿,林雪艳,尉蔚,田永杰. CXXC4增强上皮性卵巢癌细胞对化疗药物的敏感性[J]. 山东大学学报（医学版）, 2016, 54(3): 24-29.
[12] 王省,张喜雨,林炜炜,廉颖,张晴晴,李启龙,李士雪. 山东省远程医疗现状及存在问题分析[J]. 山东大学学报（医学版）, 2016, 54(2): 90-94.
[13] 郝丽静,葛树卿,王淑芬,郑文娇,张斌. 索拉非尼对顺铂耐药性舌癌Tca8113/DDP细胞增殖及凋亡影响的体外研究[J]. 山东大学学报（医学版）, 2016, 54(1): 17-21.
[14] 刘琼, 蒲业迪, 代广霞, 马家乐, 杨建霞, 李丽珍, 李颢, 王鲁群. 硼替佐米耐药多发性骨髓瘤细胞基因表达谱分析[J]. 山东大学学报（医学版）, 2015, 53(6): 33-38.
[15] 陈思, 王牧川, 任楠楠, 许巍, 王玲玲, 栾海辉, 马俊, 刘艺鸣. Parkin基因多态性与山东省汉族帕金森病发病风险的关系[J]. 山东大学学报（医学版）, 2015, 53(4): 71-74.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
版权所有 © 2018 《山东大学学报(医学版)》编辑部　
地址:山东大学科技期刊社（济南市历城区山大南路27号山东大学中心校区明德楼B座721室） 电话: 0531-88366918 E-mail: xbyxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发