Serotype and Genotype Replacement among Macrolide-Resistant Invasive Pneumococci in Adults: Mechanisms of Resistance and Association with Different Transposons
Serotype and Genotype Replacement among Macrolide-Resistant Invasive Pneumococci in Adults: Mechanisms of Resistance and Association with Different Transposons
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DOI：
10.1128/jcm.01868-09
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发表时间：
2010-04-01
影响因子：
9.4
通讯作者：
Linares, Josefina
中科院分区：
文献类型：
--
作者：
Calatayud, Laura;Ardanuy, Carmen;Linares, Josefina
本研究的目的是分析成人侵袭性肺炎球菌疾病（IPD）的趋势，由于大环内酯类耐药菌株，并研究血清型，基因型和大环内酯类耐药决定因素的演变，在1999年至2007年在西班牙巴塞罗那的前瞻性研究中收集的菌株。7价结合疫苗（PCV 7）中包含的血清型大环内酯类耐药菌株引起的IPD从2.16/100，000下降至（PCV 7前时期，1999年至2001年）降至0.80/100，000（PCV 7后期，2005年至2007年）（P = 0.001），而由非PCV 7血清型的大环内酯类耐药菌株引起的IPD从1.08/100，000增加到2.83/100，000（P < 0.001）。这些变化与PCV 7血清型克隆（ST 81 [P < 0.05]、ST 90、ST 315和ST 17）的下降以及PCV 7后期血清型19 A和24 F（ST 230）和33 F（ST 717）新克隆的增加有关。最常见的表型为MLSB（90.9%），与p53（B）基因有关。MLSB表型和四环素抗性[泰特（M）基因]之间的频繁关联与Tn 916家族的转座子如Tn 6002或Tn 3872有关。总之，1999年至2007年，巴塞罗那大环内酯类耐药肺炎球菌所致成人IPD的总体发病率保持稳定。耐大环内酯类PCV 7肺炎球菌的减少与耐大环内酯类非PCV 7肺炎球菌的增加相平衡。
The aim of this study was to analyze trends in adult invasive pneumococcal disease (IPD) due to macrolide-resistant strains and to study the evolution of serotypes, genotypes, and macrolide-resistant determinants of strains collected in a prospective study between 1999 and 2007 in Barcelona, Spain. IPD due to macrolide-resistant strains of serotypes included in the 7-valent conjugate vaccine (PCV7) decreased from 2.16/100,000 (pre-PCV7 period, 1999 to 2001) to 0.80/100,000 (late-PCV7 period, 2005 to 2007) (P = 0.001), whereas IPD due to macrolide-resistant strains of non-PCV7 serotypes increased from 1.08/100,000 to 2.83/100,000 (P < 0.001). These changes were related to a fall of clones of PCV7 serotypes (ST81 [P < 0.05], ST90, ST315, and ST17) and an increase in new clones of serotypes 19A and 24F (ST230) and 33F (ST717) in the late-PCV7 period. The most common phenotype was MLSB (90.9%), related to the erm(B) gene. The frequent association between MLSB phenotype and tetracycline resistance [tet(M) gene], was related to transposons of the Tn916-family such as Tn6002 or Tn3872. In conclusion, overall adult IPD rates due to macrolide-resistant pneumococci stabilized between 1999 and 2007 in Barcelona. The decrease in macrolide-resistant PCV7 pneumococci was balanced by the increase in macrolide-resistant non-PCV7 pneumococci.