The prevalence of aminoglycoside resistance and corresponding resistance genes in clinical isolates of staphylococci from 19 European hospitals
The prevalence of aminoglycoside resistance and corresponding resistance genes in clinical isolates of staphylococci from 19 European hospitals
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DOI：
10.1093/jac/43.2.253
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发表时间：
1999-02-01
影响因子：
5.2
通讯作者：
Jones, ME
中科院分区：
文献类型：
--
作者：
Schmitz, FJ;Fluit, AC;Jones, ME
氨基糖苷类抗生素在抗葡萄球菌治疗中仍然发挥着重要作用，尽管葡萄球菌的耐药现象很普遍。为了进一步了解欧洲氨基糖苷类抗生素耐药的流行情况，我们分别检测了来自SENTRY抗菌素监测项目的699株和249株连续的金黄色葡萄球菌和凝固酶阴性葡萄球菌（CNS）临床分离株对庆大霉素、妥布霉素、卡那霉素和链霉素的敏感性，并检查了对这些抗菌剂的敏感性与对甲氧西林的敏感性之间的关系。363株葡萄球菌分离株对至少一种检测的氨基糖苷类药物表现出耐药性;所有这些分离株均进行了aac（6 '）-Ie+aph（2“）、ant（4'）-Ia和aph（3 '）-IIIa（编码临床上最相关的氨基糖苷类修饰酶的基因）的筛选。S.来源于医院获得性肺炎的金黄色葡萄球菌分离株比来源于血液或伤口感染的分离株倾向于对氨基糖苷类和甲氧西林更耐药。In S.金黄色葡萄球菌对氨基糖苷类耐药与耐甲氧西林密切相关。S.金黄色葡萄球菌对庆大霉素的敏感性从之前的欧洲研究下降了9%，目前为77%，而CNS的敏感性目前为67%，增加了21%。虽然国内差异很大，但也存在与甲氧西林耐药性相关的地理差异。在整个欧洲对至少一种氨基糖苷类耐药的葡萄球菌中，aac（6 '）-Ie+aph（2“）、ant（4'）-Ia和aph（3 '）-IIIa分别占68%、48%和14%。aph（3 '）-IIIa在甲氧西林敏感的S.金黄色葡萄球菌和CNS分离株;相反的是真实的其他两个耐药基因。ant（4 '）-Ia和aph（3'）-IIIa基因在氨基糖苷类耐药葡萄球菌中的流行率显著高于先前欧洲研究报告的结果。
Aminoglycosides still play an important role: in antistaphylococcal therapies, although emerging resistance amongst staphylococci is widespread. To further our understanding of the prevalence of aminoglycoside resistance in Europe, we tested 699 and 249 consecutive unrelated clinical isolates of Staphylococcus aureus and coagulase-negative staphylococci (CNS), respectively, from the SENTRY Antimicrobial Surveillance Program, for susceptibility to gentamicin, tobramycin, kanamycin and streptomycin, and examined the relationship between susceptibility to these antimicrobials and susceptibility to methicillin. Three hundred and sixty-three staphylococcal isolates demonstrated resistance to at least one of the aminoglycosides tested; all of these isolates were screened for the presence of aac(6')-Ie+aph(2 "), ant(4')-Ia and aph(3')-IIIa, the genes encoding the most clinically relevant aminoglycoside-modifying enzymes. S. aureus isolates derived from hospital-acquired pneumonia tended to be more resistant to aminoglycosides and methicillin than isolates from blood or wound infections. In S. aureus, resistance to aminoglycosides was closely associated with methicillin resistance. Susceptibility of S. aureus to gentamicin has decreased by 9% from previous European studies to a current level of 77%, while susceptibility of CNS, currently at 67%, has increased by 21%. Geographical variation occurred, correlating with methicillin resistance, although intra-country variation was considerable. aac(6')-Ie+aph(2 "), ant(4')-Ia and aph(3')-IIIa were found throughout Europe in 68%, 48% and 14% respectively of staphylococci resistant to at least one aminoglycoside. aph(3')-IIIa was considerably more common in methicillin-susceptible S. aureus and CNS isolates; the reverse was true for the other two resistance genes. The prevalence of ant(4')-Ia and aph(3')-IIIa genes in aminoglycoside-resistant staphylococci was significantly greater than that reported in previous European studies.