粪肠球菌对泰利霉素药物敏感性与耐药基因erm的分布
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摘要
目的了解粪肠球菌对泰利霉素和其他常用抗菌药物的耐药性,以及泰利霉素耐药与红霉素耐药相关基因ermA、ermB、ermC之间的关系。方法对本院2010-2016年从各种临床标本收集鉴定的320株粪肠球菌,用微量肉汤稀释法测定这些菌株对泰利霉素及8种临床常用抗菌药物的最小抑菌浓度,并用PCR法检测耐药基因ermA、ermB、ermC的分布。结果320株粪肠球菌对泰利霉素中介耐药26株,耐药138株,耐药率达51.3%;对红霉素耐药率达95.6%,泰利霉素抗粪肠球菌效果优于红霉素。对利奈唑胺、万古霉素、呋喃妥因和氨苄西林耐药率分别为15.6%、0.6%、2.2%和0.6%。共10株(3.1%)携带ermA基因,207株(64.7%)携带ermB基因,对泰利霉素中介组中有23株ermB基因阳性,耐药组有131株ermB基因阳性,仅1株(0.3%)ermC基因阳性,该菌同时携带ermB基因。结论粪肠球菌对泰利霉素已有较高耐药率。粪肠球菌对泰利霉素MIC值改变与ermB基因密切相关,与ermA、ermC基因无明显相关性。
Objective To determine the resistance rates of Enterococcus faecalis to commonly used antibiotics including Telithromycin,and explore the relationships between the resistance of E.faecalis to Telithromycin and the distribution of Erythromycin-resistance relevant genes ermA,ermB and ermC.Methods 320 strains of E.faecalis were isolated from different clinical specimens during 2010-2016,and micro-broth dilution method was used to detect the MICs of Telithromycin and other 8 antibiotics.PCR was performed to detect the distribution of resistance genes ermA,ermB and ermC.Results 26 strains of E.faecalis were intermediate-resistant while 138 strains resistant to Telithromycin,at a resistant rate up to 51.3%.95.6% of the E.faecalis strains were resistant to Erythromycin.Telithromycin was superior to Erythromycin in term of anti-E.faecalis effect.The resistance rates of E.faecalis to Linezolid,Vancomycin,Nitrofurantoin and Ampicillin were 15.6%,0.6%,2.2% and 0.6% respectively.10(3.1%)strains carried ermA and 207(64.7%)strains carried ermB.There were 23 ermB positive strains in the intermediate-resistance group,and 131 ermB positive ones in the resistance group.There was only 1(0.3%)ermC positive strain which carried ermB too.Conclusion E.faecalis has a high resistance rate to Telithromycin.The changing MIC of Telithromycin to E.faecalis is closely related to ermB gene.
Objective To determine the resistance rates of Enterococcus faecalis to commonly used antibiotics including Telithromycin,and explore the relationships between the resistance of E.faecalis to Telithromycin and the distribution of Erythromycin-resistance relevant genes ermA,ermB and ermC.Methods 320 strains of E.faecalis were isolated from different clinical specimens during 2010-2016,and micro-broth dilution method was used to detect the MICs of Telithromycin and other 8 antibiotics.PCR was performed to detect the distribution of resistance genes ermA,ermB and ermC.Results 26 strains of E.faecalis were intermediate-resistant while 138 strains resistant to Telithromycin,at a resistant rate up to 51.3%.95.6% of the E.faecalis strains were resistant to Erythromycin.Telithromycin was superior to Erythromycin in term of anti-E.faecalis effect.The resistance rates of E.faecalis to Linezolid,Vancomycin,Nitrofurantoin and Ampicillin were 15.6%,0.6%,2.2% and 0.6% respectively.10(3.1%)strains carried ermA and 207(64.7%)strains carried ermB.There were 23 ermB positive strains in the intermediate-resistance group,and 131 ermB positive ones in the resistance group.There was only 1(0.3%)ermC positive strain which carried ermB too.Conclusion E.faecalis has a high resistance rate to Telithromycin.The changing MIC of Telithromycin to E.faecalis is closely related to ermB gene.
引文
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[13]Sánchez-Molina MI,Martín D,Valladares C,et al.Susceptibility of Enterococcus genus to new antimicrobial agents[J].Rev Esp Quimioter,2004,17(2):184-188.
[14]Kwon AR,Yoon EJ,Yoon JM,et al.Activities of Clindamycin,Synercid,Telithromycin,Linezolid,and Mupirocin against Gram-positive coccal strains resistant to Erythromycin in Korea[J].Arch Pharm Res,2007,30(7):840-843.
[15]Hisanaga T,Hoban DJ,Zhanel GG.Mechanisms of resistance to Telithromycin in Streptococcus pneumoniae[J].J Antimicrob Chemother,2005,56(3):447-450.
[16]Min YH,Yoon EJ,Kwon AR,et al.Alterations in regulatory regions of erm(B)genes from clinical isolates of Enterococci resistant to Telithromycin[J].Arch Pharm Res,2011,34(12):2149-2154.
[17]Canu A,Malbruny B,Coquemont M,et al.Diversity of ribosomal mutations conferring resistance to macrolides,clindamycin,streptogramin,and telithromycin in Streptococcus pneumoniae[J].Antimicrob Agents Chemother,2002,46(1):125-131.
[2]Miller WR,Munita JM,Arias CA.Mechanisms of antibiotic resistance in enterococci[J].Expert Rev Anti-infect Ther,2014,12(10):1221-1236.
[3]Hershberger E,Donabedian S,Konstantinou K,et al.Quinupristin-dalfopristin resistance in grampositive bacteria:Mechanism of resistance and epidemiology[J].Clin Infect Dis,2004,38(1):92-98.
[4]Portillo A,Ruiz-Larrea F,Zarazaga M,et al.Macrolide resistance genes in Enterococcus spp[J].Antimicrob Agents Chemother,2000,44(4):967-971.
[5]Shoji T,Takaya A,Sato Y,et al.RlmCD-mediated U747methylation promotes efficient G748 methylation by methyltransferase RlmAII in 23SrRNA in Streptococcus pneumoniae;interplay between two rRNA methylations responsible for telithromycin susceptibility[J].Nucleic Acids Res,2015,43(18):8964-8972.
[6]Zeitlinger M,Wagner CC,Heinisch B.Ketolides-The modern relatives of macrolides the pharmacokinetic perspective[J].Clin Pharmacokinet,2009,48(1):23-38.
[7]Takaya A,Kitagawa N,Kuroe Y,et al.Mutational analysis of reduced telithromycin susceptibility of Streptococcus pneumoniae isolated clinically in Japan[J].FEMS Microbiol Lett,2010,307(1):87-93.
[8]CLSI]Clinical and Laboratory Standards Institute.Performance standards for antimicrobial susceptibility testing[S].25th informational supplement,M100-S26.Wayne,PA:CLSI.2016.
[9]Bai B,Hu KT,Li H,et al.Effect of tedizolid on clinical Enterococcus isolates:In vitro activity,distribution of virulence factor,resistance genes and multilocus sequence typing[J].FEMS Microbiol Lett,2018,365(3):1-7.
[10]Woodford N,Livermore DM.Infections caused by Gram-positive bacteria:A review of the global challenge[J].J Infect,2009,59(Suppl 1):s4-s16.
[11]YANG Qing,YU Yunsong,LIN Jie,et al.Resistance profile of Enterococcus in hospitals across China:Results of CHINETAntimicrobial Resistance Surveillance Program,2005-2014[J].Chin J Infect Chemother,2016,16(2):146-152.(in Chinese)杨青,俞云松,林洁,等.2005-2014年CHINET肠球菌属细菌耐药性监测[J].中国感染与化疗杂志,2016,16(2):146-152.
[12]YANG Ping,SUN Shan,ZHANG Liping.Surveillance of antibiotic resistance of 1264strains of Enterococcus faecalis and Enterococcus faecium in Chongqing[J].Chin J Microecol,2013,25(9):1028-1031.(in Chinese)阳苹,孙珊,张莉萍.重庆市1264株粪肠球菌和屎肠球菌耐药性监测[J].中国微生态学杂志,2013,25(9):1028-1031.
[13]Sánchez-Molina MI,Martín D,Valladares C,et al.Susceptibility of Enterococcus genus to new antimicrobial agents[J].Rev Esp Quimioter,2004,17(2):184-188.
[14]Kwon AR,Yoon EJ,Yoon JM,et al.Activities of Clindamycin,Synercid,Telithromycin,Linezolid,and Mupirocin against Gram-positive coccal strains resistant to Erythromycin in Korea[J].Arch Pharm Res,2007,30(7):840-843.
[15]Hisanaga T,Hoban DJ,Zhanel GG.Mechanisms of resistance to Telithromycin in Streptococcus pneumoniae[J].J Antimicrob Chemother,2005,56(3):447-450.
[16]Min YH,Yoon EJ,Kwon AR,et al.Alterations in regulatory regions of erm(B)genes from clinical isolates of Enterococci resistant to Telithromycin[J].Arch Pharm Res,2011,34(12):2149-2154.
[17]Canu A,Malbruny B,Coquemont M,et al.Diversity of ribosomal mutations conferring resistance to macrolides,clindamycin,streptogramin,and telithromycin in Streptococcus pneumoniae[J].Antimicrob Agents Chemother,2002,46(1):125-131.