| 育龄妇女分离无乳链球菌对氟喹诺酮类抗生素的耐药性及耐药机制研究 |
| 投稿时间：2014-11-25 修订日期：2015-01-15 点此下载全文 |
| 引用本文：赵丽琴.育龄妇女分离无乳链球菌对氟喹诺酮类抗生素的耐药性及耐药机制研究[J].医学研究杂志,2015,44(8):149-151 |
| DOI：
10.11969/j.issn.1673-548X.2015.08.043 |
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| 中文摘要:目的 研究5年来分离育龄妇女的无乳链球菌对氟喹诺酮类抗生素的耐药性及耐药机制,为临床上合理使用抗菌药物提供理论依据。 方法 收集笔者医院2009年1月~2014年1月5年间就诊的育龄妇女分离的无乳链球菌253株,回顾性调查无乳链球菌引起感染的类型,采用Vitek-2 compact全自动细菌鉴定和药敏系统对菌株MIC进行测定。用PCR分别扩增氟喹诺酮类耐药菌株的parC和gyrA基因,并进行测序和序列分析。 结果 253株无乳链球菌中,187株来自女性宫颈分泌物,占73.9%;其余菌株来自尿液、血液和脓液等标本。药敏结果回顾性分析,对头孢噻肟、头孢曲松、头孢吡肟和万古霉素的敏感度均为100%,对青霉素和氨苄西林的敏感度较高,分别为98.4%和93.3%,对四环素的耐药率高达94.1%, 对左氧氟沙星不敏感均为71.1%。57.5%左氧氟沙星耐药无乳链球菌同时存在parC(ser79/Tyr)和gyrA(Ser8l/Leu)基因突变,73.3%中介菌株检测到单独parC(ser79/Tyr)基因突变。而仅15.1%敏感菌株检测到单独parC(ser79/Tyr)基因突变。此外,另有10株耐药和5株中介菌株未检测到parC和gyrA基因突变。 结论 左氧氟沙星不敏感无乳链球菌parC基因和gyrA基因的突变类型均分别以ser79/Tyr和Ser8l/Leu突变为主,应加强对育龄妇女进行无乳链球菌的筛查工作,加强无乳链球菌的耐药性监测。 |
| 中文关键词:育龄妇女 感染 氟喹诺酮类抗菌药物 无乳链球菌 |
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| Study on Resistance Mechanism of Fluoroquinolone-resistant Streptococcus agalactiae Separated from Women of Childbearing Age |
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| Abstract:Objective To investigate the detection and resistance mechanism of fluoroquinolone-resistant Streptococcus agalactiae isolated from women of childbearing age in five years, and provide a theoretical basis for the rational use of antimicrobial drugs clinically. Methods Two hundred and fifty-three Streptococcus agalactiae isolates were collected from our hospital in five years from Jan 2009 to 2014. We used the Vitek-2 compact automated system to identify the Streptococcus agalactiae and measure the MIC. Meanwhile, PCR was used to amplify the ParC and gyrA genes, and all the PCR products were send to sequence to confirm. Results Among the 253 S. agalactiae, 187 stains were isolated from the vaginal fornix secretion samples, which was accounting for 73.9%. The other strains were isolated from the urine, blood and pus samples. A retrospective analysis of susceptibility data showed that the susceptible rate of cefotaxime, ceftriaxone, cefepime and vancomycin were 100%, while the susceptible rate of penicillin and ampicillin were 98.4% and 93.3%. The resistance rate of tetracycline was the highest, which was accounted for 94.1%. In addition, the non-susceptible rate of levofloxacin was 71.1%. 57.5% of levofloxacin-resistant Streptococcus agalactiae co-existed the parC (ser79/Tyr) and gyrA (Ser8l/Leu) gene mutation. 73.3% intermediate-susceptible strains were detected with parC (ser79/Tyr) gene mutation separately. However, only 15.1% susceptible strains detected with parC (ser79/Tyr) gene mutation separately. In addition, 10 resistant strains and five intermediate strains were not detected parC and gyrA mutations. Conclusion The mutation of parC and gyrA genes in levofloxacin non-sensitive strains were mainly based on the ser79/Tyr and Ser8l/Leu mutation types, respectively. Meanwhile, we should strengthen the Streptococcus agalactiae screening in the women of childbearing age and strengthen monitoring of drug resistance. |
| keywords:Women of childbearing age Infection Fluoroquinolone Streptococcus agalactiae |
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