Antibiotic susceptibility according to genotype of penicillin-binding protein and macrolide resistance genes, and serotype of Streptococcus pneumoniae isolates from community-acquired pneumonia in children
Antibiotic susceptibility according to genotype of penicillin-binding protein and macrolide resistance genes, and serotype of Streptococcus pneumoniae isolates from community-acquired pneumonia in children
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DOI：
10.1093/jac/dki302
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发表时间：
2005-10-01
影响因子：
5.2
通讯作者：
Ubukata, K
中科院分区：
文献类型：
--
作者：
Chiba, N;Kobayashi, R;Ubukata, K
目的：分析肺炎链球菌对抗生素的敏感性、对β-内酰胺类和大环内酯类抗生素耐药的基因及血清型。方法：从2002年5月至2004年5月的社区获得性肺炎患儿中分离出392株肺炎链球菌。根据聚合酶链式反应检测到的pbp1a、pbp2x和pbp2b基因突变，将所有菌株分为6种基因型。结果：39%的菌株有一个或两个PBP基因突变(gPisp，其中pisp代表青霉素耐药肺炎链球菌)，52.3%的菌株有三个基因突变(gprsp代表青霉素耐药肺炎链球菌)。大环内酯类耐药基因以mef(A)、erm(B)和erm(B)为主，分别为30.6%、48.5%和7.7%。最常见的血清型是：6B(23.2%)、23F(17.6%)、19F(17.3%)、14(10.5%)和6A(8.2%)。七价结合疫苗的血清型占分离株的70.9%，占gPRSP的89.8%。头孢噻肟MIC=2 mg/L的菌株的血清型几乎都是疫苗型。结论：在日本，在婴幼儿中引入结合疫苗是预防肺炎球菌感染的必要措施。
Objectives: Antibiotic susceptibilities, genes mediating beta-lactam and macrolide resistance, and serotypes were analysed for strains of Streptococcus pneumoniae.Methods: A total of 392 strains of S. pneumoniae were isolated from paediatric patients with community-acquired pneumonia between May 2002 and 2004. All strains were classified into six genotype patterns according to the mutations found in the pbp1a, pbp2x and pbp2b genes identified by PCR. These results are represented by adding 'g', indicating genotypic identification.Results: Thirty-nine per cent of the isolates showed mutations in either one or two PBP genes (gPISP, where PISP stands for penicillin-intermediate resistant S. pneumoniae) and 52.3% had mutations in three genes (gPRSP, where PRSP stands for penicillin-resistant S. pneumoniae). The majority of the strains had a macrolide resistance gene: mef(A), (30.6%); erm(B), (48.5%); or both mef(A) and erm(B), (7.7%). The most frequent serotypes of these strains were: 6B (23.2%), 23F (17.6%), 19F (17.3%), 14 (10.5%) and 6A (8.2%). Serotypes of the seven-valent conjugate vaccine covered 70.9% of all isolates, and 89.8% of gPRSP. Serotypes of the strains with cefotaxime MICs of >= 2 mg/L were almost all of a vaccine type.Conclusions: The results suggest that introduction of conjugate vaccines into infants and children is necessary for the prevention of pneumococcal infections in Japan.