High prevalence of erythromycin-resistant Bordetella pertussis in Xi'an, China
High prevalence of erythromycin-resistant Bordetella pertussis in Xi'an, China
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DOI：
10.1111/1469-0691.12671
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发表时间：
2014-11-01
影响因子：
14.2
通讯作者：
He, Q.
中科院分区：
文献类型：
--
作者：
Wang, Z.;Cui, Z.;He, Q.
百日咳的病原体百日咳博德泰拉对红霉素的耐药性是罕见的。最近，一些中国分离株被发现对红霉素具有耐药性。本研究旨在调查西安市持续咳嗽儿童百日咳的发生率及百日咳对红霉素的耐药情况。本研究纳入2012年1月至2013年12月在西安市儿童医院收治的疑似百日咳患者313例，采集其鼻咽拭子进行培养和pcr（针对IS481和ptx-Pr）。pcr测序直接从NP样本中鉴定百日咳杆菌23S rRNA的A2047G突变。培养阳性16例（5.1%），IS481 PCR阳性168例（53.7%）。168份IS481 PCR阳性样本中，ptx-Pr和23S rRNA PCR阳性样本分别为122份（72.6%）和100份（59.5%）。所有培养阳性样本也均为三种pcr阳性。16株百日咳分枝杆菌中有14株（87.5%）对红霉素耐药（mic 0 ~ 256mg/L）。14株分离株均具有23S rRNA的A2047G同源突变。在100份23S rRNA PCR阳性样本中，测序发现85份（85.0%）存在A2047G突变。我们的研究结果表明，在中国西安市，百日咳在幼儿中仍然流行，并且流行的百日咳菌株大多是红霉素耐药的。
Resistance of Bordetella pertussis, the causative agent of pertussis, to erythromycin is rare. Recently, several Chinese isolates were found to be erythromycin resistant. This study aimed to investigate the occurrence of pertussis in children suffering persistent cough and the prevalence of B.pertussis resistance to erythromycin in Xi'an, China. Three hundred and thirteen patients with suspected pertussis admitted to Xi'an Children's Hospital from January 2012 through to December 2013 were included and their nasopharyngeal (NP) swabs were taken for culture and PCRs (targeting IS481 and ptx-Pr). PCR-based sequencing was used to identify the A2047G mutation of B.pertussis 23S rRNA directly from the NP samples. Sixteen (5.1%) and 168 (53.7%) patients were positive for culture and IS481 PCR. Of the 168 samples positive for IS481 PCR, 122 (72.6%) and 100 (59.5%) were positive for ptx-Pr and 23S rRNA PCRs, respectively. All culture-positive samples were also positive for the three PCRs. Fourteen (87.5%) of the 16 B.pertussis isolates were found to be resistant to erythromycin (MICs>256mg/L). All the 14 isolates were confirmed to have a homogeneous A2047G mutation of 23S rRNA. Of the 100 samples positive for 23S rRNA PCR, 85 (85.0%) were found to have the A2047G mutation by sequencing. Our results indicate that in Xi'an, China, pertussis remains endemic in young children, and the circulating B.pertussis strains are mostly erythromycin resistant.