肺炎链球菌对大环内酯类耐药性分析

ANALYSIS OF STREPTOCOCCUS PNEUMONIA'S DRUG RESISTANCE TO MACROLIDES

目的探索郯城县区肺炎链球菌分离株对大环内酯类耐药性及其治疗情况。方法收集郯城县社区和临床分离的肺炎链球菌,根据CLSI标准,用K-B法、Etest法检测肺炎链球菌对红霉素和克林霉素的耐药性及对红霉素的耐药表型。结果 493株肺炎链球菌中红霉素不敏感菌株489株,对克林霉素不敏感菌株482株,其中ermB基因介导的红霉素耐药菌株482株,占98.6%,mefE基因介导的红霉素耐药菌株7株,占1.4%。结论郯城县区对红霉素和克林霉素近乎全部耐药,ermB基因介导的靶位改变是郯城县区肺炎链球菌对大环内酯类抗菌药物的主要耐药机制。

Objective To explore streptococcus pneumonia＇s drug resistance to macrolides . Methods Samples of streptococcus pneumonia were collected from the communities in Tancheng County and the iso-lated ones from clinical treatment .According to the CLSI standard ,K-B method and Etest were used to detect streptococcus pneumonia ＇ s drug resistance to erythromycin and clindamycin and the resistance phenotype of erythromycin . Results In the 493 strains of streptococcus pneumonia ,489 strains were not sensi-tive to erythromycin ,482 strains were not sensitive to clindamycin .482 drug-resistant strains were mediated by ermB gene ,accounting for 98 .6% of all the strains .7 drug-resistant strains were mediated by mefE gene ,accounting for 1 .4% .Conclusion Erythro-mycin and clindamycin has no obvious effect on streptococcus pneumoniae in this county . T he target change of mediating by ErmB gene is the main mechanism of streptococcus pneumonia ＇s resistance to mac-rolides .