Macrolide resistance determinants of group A streptococci in Ankara, Turkey
Macrolide resistance determinants of group A streptococci in Ankara, Turkey
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DOI：
10.1093/jac/dkg300
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发表时间：
2003-07-01
影响因子：
5.2
通讯作者：
Tuncer, S
中科院分区：
文献类型：
--
作者：
Acikgoz, ZC;Gocer, S;Tuncer, S
目的：首次定义了土耳其安卡拉 A 族链球菌 (GAS) 的大环内酯-林可酰胺-链阳菌素 B (MLSB) 耐药性决定因素。 分离株和方法：对从安卡拉三个不同地区收集的总共 1355 株 GAS 分离株进行了红霉素耐药性筛选。通过三盘试验确定抗性表型，并通过 PCR 确定相关基因决定因素。测量了耐药菌株对红霉素、克林霉素和螺旋霉素的 MIC，并测定了对其他抗生素的敏感率。结果：36 株菌株（2.6%）对红霉素耐药。其中，17 个（47.2%）表达大环内酯类限制性耐药（M 表型），而其余的则表达诱导型（16 个分离株，44.4%）或组成型（3 个分离株，8.3%）MLSB 耐药。 M 表型的所有分离株均含有 mef(A) 基因。在非 M 分离株中，14 个带有 erm(A) 亚类 erm(TR)，5 个带有 erm(B) 基因。四环素耐药性与诱导表型之间存在显着相关性（P < 0.05）。成人大环内酯类耐药率显着升高（P<0.05），2002年比2001年增加两倍多（P<0.05）。结论：安卡拉GAS中大环内酯类耐药率较低；因此，针对这些药物进行常规抗菌药物敏感性测试似乎是没有根据的。
Objectives: Macrolide-lincosamide-streptogramin B (MLSB) resistance determinants of group A streptococci (GAS) in Ankara, Turkey, were defined for the first time.Isolates and methods: A total of 1355 GAS isolates, collected from three different regions of Ankara, were screened for erythromycin resistance. Resistance phenotypes were determined by a triple-disc test, and the gene determinants responsible were determined by PCR. MICs of erythromycin, clindamycin and spiramycin were measured for the resistant isolates, and susceptibility rates to some further antibiotics were determined.Results: Thirty-six isolates (2.6%) were resistant to erythromycin. Of these, 17 (47.2%) expressed macrolide-restricted resistance (M phenotype), while the remainder expressed inducible (16 isolates, 44.4%) or constitutive (three isolates, 8.3%) MLSB resistance. All isolates of the M phenotype harboured the mef(A) gene. Of non-M isolates, 14 harboured erm(A) subclass erm(TR) and five had erm(B) genes. There was a significant relationship between tetracycline resistance and the inducible phenotype (P < 0.05). Macrolide resistance was significantly higher in adults (P < 0.05), and increased more than two-fold in 2002 compared with 2001 (P < 0.05).Conclusion: The prevalence of macrolide resistance in GAS is low in Ankara; therefore, routine antimicrobial susceptibility testing against these agents seems unwarranted.