Antimicrobial susceptibility and genetic characteristics of Streptococcus pneumoniae isolates indicating possible nosocomial transmission routes in a community hospital in Japan
Antimicrobial susceptibility and genetic characteristics of Streptococcus pneumoniae isolates indicating possible nosocomial transmission routes in a community hospital in Japan
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DOI：
10.1128/jcm.01138-07
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发表时间：
2007-11-01
影响因子：
9.4
通讯作者：
Watanabe, Hiroshi
中科院分区：
文献类型：
--
作者：
Qin, Liang;Masaki, Hironori;Watanabe, Hiroshi
一项临床研究旨在研究2001年4月至2002年11月从日本一家社区医院回收的肺炎链球菌分离株。共有73株分离株被定义为来自住院患者、门诊患者和医院工作人员群体。MIC结果显示，20株（27.4%）对青霉素G敏感，39株（53.4%）为中度耐药，14株（19.2%）为完全耐药。还检测到对大环内酯类药物的低敏感性：所有菌株中分别有32.9%、32.9%和34.2%对红霉素、克拉霉素和阿奇霉素耐药。30株（41%）对至少两种不同的抗生素耐药。除2株无法分型的菌株外，共检出19种不同的血清型，主要血清型为19 F和23 F。脉冲场凝胶电泳（PFGE）模式A在血清型19 F组中占主导地位;该模式与国际克隆台湾19 F相似。在23 F组中检测到总共10种不同的模式，并且与国际克隆西班牙23 F和台湾23 F的模式相区别。模式B菌株被确定在同一病房，和模式d菌株发现在医院内肺炎球菌感染（NPI）的患者和门诊病人。因此，耐药S.肺炎流行迅速，尤其是血清型19 F和23 F群的分离株。PFGE数据揭示了患者间的传播，并表明NPI患者菌株和门诊菌株之间可能存在某种关联。
A clinical study was designed to study Streptococcus pneumoniae isolates recovered from a community hospital in Japan from April 2001 to November 2002. A total of 73 isolates were defined as derived from inpatient, outpatient, and hospital staff groups. The MIC results showed that 20 strains (27.4%) were susceptible to penicillin G, 39 strains (53.4%) had intermediate resistance, and 14 strains (19.2%) had full resistance. Low susceptibility to macrolides was also detected: 32.9%, 32.9%, and 34.2% of all strains were resistant to erythromycin, clarithromycin, and azithromycin, respectively. Thirty strains (41%) were resistant to at least two different kinds of antibiotics. Nineteen disparate serotypes were detected besides two nontypeable strains, and the predominant serotypes were 19F and 23F. Pulsed-field gel ellectrophoresis (PFGE) pattern A was dominant in the serotype 19F group; this pattern was similar to that of the international clone Taiwan 19F. A total of 10 different patterns were detected in the 23F group and were distinguishable from those of the international clones Spain 23F and Taiwan 23F. Pattern b strains were identified in the same ward, and pattern d strains were found both in patients with nosocomial pneumococcal infections (NPI) and in outpatients. In conclusion, drug-resistant S. pneumoniae was spreading rapidly, especially isolates of the serotype 19F and 23F groups. PFGE data revealed interpatient transmission and suggested that there might be some association between NPI patient strains and outpatient strains.