目的 了解河北省侵袭性肺炎链球菌(Streptococcus pneumoniae, Spn)19F型和19A型的耐药特征及多位点序列分型(multilocus sequence type, MLST)分布。 方法 19F型和19A型采用多重聚合酶链式反应(multiplex polymerase chain reaction,mPCR)进行筛选分析;采用微量营养肉汤稀释法对其进行11种常见药物的药物敏感性试验,测定其最低抑菌浓度值(minimum inhibitory concentration, MIC)并进行药物敏感性的判断;采用MLST技术对菌株进行序列分型分析。结果 15株19F型侵袭性Spn对利奈唑胺、万古霉素、左氧氟沙星呈现出完全敏感。9株19A型侵袭性Spn对氯霉素、利奈唑胺、万古霉素、头孢噻肟、左氧氟沙星呈现出完全敏感。15株19F型侵袭性Spn共检出4种序列分型(sequence type, ST),3株属于新的ST型,优势STs为ST-271(9株,60.00%);9株19A型侵袭性Spn共检出2种ST型,优势STs为ST-320(8株,88.89%)。结论 本地区19F型和19A型侵袭性Spn耐药现象较为严重,且存在多重耐药;19F型的基因型具有多变性和复杂性,而19A型的基因型则较为紧凑。
Abstract
Objective To investigate the antibiotic resistance characteristics of Streptococcus pneumoniae invasive serotypes 19F and 19A isolates and the distribution of multi-locus sequence type (MLST) in Hebei Province. Methods Multiplex polymerase chain reaction (mPCR) assay was used to determine the serotypes 19F and 19A. Microdilution broth method was employed to test the antibiotic resistance to 11 drugs. The minimum inhibitory concentration (MIC) was determined, and the antibiotic resistance was analyzed. MLST was performed to determine the sequence types (STs) of serotypes 19F and 19A. Results Fifteen strains of Streptococcus pneumoniae invasive serotype 19F were completely sensitive to linezolid, vancomycin and levofloxacin hydrochloride. Nine strains of Streptococcus pneumoniae invasive serotype 19A were completely susceptible to chloromycetin, linezolid, vancomycin, cefotaxime and levofloxacin hydrochloride. Four STs were detected in fifteen strains of Streptococcus pneumoniae invasive serotype 19F, three of which belonged to the new STs, and the dominant ST was ST-271 (9 strains, 60.00%). Two STs were detected in nine strains of Streptococcus pneumoniae invasive serotype 19A, and the dominant ST was ST-320 (8 strains, 88.89%). Conclusion The antibiotic resistance of Streptococcus pneumoniae invasive serotypes 19F and 19A isolates in Hebei Province is serious, and there exists a multiple drug resistance pattern. The genotypes of Streptococcuspneumoniae invasive serotype 19F are variable and complex, while the genotypes of Streptococcus pneumoniae invasive serotype 19A are compact.
关键词
侵袭性肺炎链球菌 /
血清型19F /
血清型19A /
耐药性 /
多位点序列分型
{{custom_keyword}} /
Key words
invasive Streptococcus pneumonia /
serotype 19F /
serotype 19A /
antibiotic resistance /
multi-locus sequence type
{{custom_keyword}} /
中图分类号：
R563.1
{{custom_clc.code}}
({{custom_clc.text}})
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Bogaert D,de Groot R,Hermans PW.Streptococcus pneumoniae colonization:the key to pneumococcal disease[J].Lancet Infect Dis,2004,4(3):144-154.
[2] 刘民,马秋月.肺炎链球菌相关疾病流行病学研究进展[J].中国公共卫生,2018,34(11):1449-1452.
[3] Pan F,Han L,Huang W,et al.Serotype distribution,antimicrobial susceptibility,and molecular epidemiology of Streptococcus pneumoniae isolated from children in Shanghai,China[J].PLoS One,2015,10(11):e0142892.
[4] Denham BC,Clarke SC.Serotype incidence and antibiotic susceptibility of Streptococcus pneumoniae causing invasive disease in Scotland,1999-2002[J].J Med Microbiol,2005,54(Pt 4):327-331.
[5] 中华医学会儿科学分会,中华预防医学会.儿童肺炎链球菌性疾病防治技术指南(2009年版)[J].中华儿科杂志,2010,48(2):104-111.
[6] 邓力,印根权.侵袭性肺炎链球菌病研究进展[J].临床儿科杂志,2009,27(1):94-97.
[7] 刘春林,赵春江,刘昱东,等.侵袭性肺炎链球菌148株血清型、耐药性及分子分型研究[J].中华医学杂志,2010,90(22):1565-1570.
[8] 王颖童,郭映辉,王茜,等.河北省2014年43株侵袭性肺炎链球菌血清型分析[J].中国疫苗和免疫,2016,22(1):6-9.
[9] World Health Organization.Laboratory methods for the diagnosis of meningitis caused by Neisseria meningitidis,Streptococcus pneumoniae and Haemophilus influenzae.WHO manual[Z].2011-12-01.
[10] 李迟佳,王亚亭.侵袭性肺炎链球菌疾病的研究进展[J].中华实用儿科临床杂志,2010,25(10):776-778.
[11] Chen Y,Deng W,Wang SM,et al.Burden of pneumonia and meningitis caused by Streptococcus pneumoniae in China among children under 5 years of age:a systematic literature review[J].PLoS One,2011,6(11):e27333.
[12] 歹丽红,董琳,李海燕,等.儿童侵袭性与非侵袭性肺炎链球菌耐药性的对照研究[J].中国当代儿科杂志,2015,(4):303-307.
[13] 宁桂军,尹遵栋.中国肺炎球菌病疾病负担研究进展[J].中国公共卫生,2018,34(11):13-15.
[14] Dunne EM,Tikkanen L,Balloch A,et al.Characterization of 19A-like 19F pneumococcal isolates from Papua New Guinea and Fiji[J].New Microb New Infect,2015,7:86-88.
[15] Jenkins SG,Brown SD,Farrell DJ.Trends in antibacterial resistance among Streptococcus pneumoniae isolated in the USA:update from PROTEKT US Years 1–4[J].Ann Clin Microb Antimicrob,2008,7(1):1.
[16] Low DE,de Azavedo J,Weiss K,et al.Antimicrobial resistance among clinical isolates of Streptococcus pneumoniae in Canada during 2000[J].Antimicrob Agents Chemother,2002,46(5):1295-1301.
[17] 姚开虎,史伟.儿童肺炎链球菌耐药现状[J].中华实用儿科临床杂志,2016,31(4):252-256.
[18] 李真,戴丽.氟喹诺酮类抗菌药物在成人社区下呼吸道感染中的临床应用[J].中华医院感染学杂志,2010,20(4):595-597.
[19] Maiden MC,Bygraves JA,Feil E,et al.Multilocus sequence typing:a portable approach to the identification of clones within populations of pathogenic microorganisms[J].Proc Natl Acad Sci U S A,1998,95(6):3140-3145.
[20] Urwin R,Maiden MC.Multi-locus sequence typing:a tool for global epidemiology[J].Trends Microbiol,2003,11(10):479-487.
[21] 周婧杰,叶惠芬,徐邦牢,等.广州地区老年人肺炎链球菌临床分离株的青霉素耐药研究与分子分型[J].热带医学杂志,2008,8(10):1020-1023.
[22] Moore MR,Gertz RE,Woodbury RL,et al.Population snapshot of emergent Streptococcus pneumoniae serotype 19A in the United States,2005[J].J Infect Dis,2008,197(7):1016-1027.
[23] 孙嘉璐,唐倩如,王海滨.13价肺炎球菌多糖结合疫苗安全性的meta分析[J].实用预防医学,2019,26(7):871-873.
[24] 王华庆,安志杰.肺炎球菌性疾病免疫预防专家共识(2017版)[J].中国预防医学杂志,2018,19(3):161-191.
[25] Weinberger DM,Malley R,Lipsitch M.Serotype replacement in disease after pneumococcal vaccination[J].Lancet,2011,378(9807):1962-1973.
{{custom_fnGroup.title_cn}}
脚注
{{custom_fn.content}}
基金
河北省科技计划项目课题(16277745D);河北省科技支撑项目课题(14277733D)
{{custom_fund}}
PDF(1089 KB)
