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J Antimicrob Chemother:链球菌耐药在逐渐增加?

2017-03-26 MedSci MedSci原创

近期,J Antimicrob Chemother杂志中有一篇文章报道,链球菌耐药的频率在逐渐的上升,我们应该要引起重视。在美国,无乳链球菌(GBS)是引起脑膜炎、败血症、新生儿肺炎的一个主要原因。也可导致导致老年人及处于医疗环境中的大龄婴儿、孕妇、儿童、年轻人的侵袭性疾病。对林可霉素类耐药而对红霉素不耐药的GBS很少见。但是,先前在却有这样的临床分离菌株的报道,同时对链阳霉素A及截短侧耳素均耐药

近期,J Antimicrob Chemother杂志中有一篇文章报道,链球菌耐药的频率在逐渐的上升,我们应该要引起重视。

在美国,无乳链球菌(GBS)是引起脑膜炎、败血症、新生儿肺炎的一个主要原因。也可导致导致老年人及处于医疗环境中的大龄婴儿、孕妇、儿童、年轻人的侵袭性疾病。对林可霉素类耐药而对红霉素不耐药的GBS很少见。但是,先前在却有这样的临床分离菌株的报道,同时对链阳霉素A及截短侧耳素均耐药。

回顾性的在活性细菌监督中心进行筛选,选出这种具有特定表型的GBS细菌株,以确定其引起耐药的遗传因素,以及耐药的频率是否在逐渐增加。

在MIC数据库21186GBS菌株中,检测出有65株 (0.31%)对红霉素敏感(MIC ≤0.25mg/L),而对克林霉素不敏感(MIC ≥0.5mg/L)的菌株。这些菌株的基因组DNA均被提取,对WGS也进行了采集。先前与LAS有关的10个基因组被用于测序短序列匹配研究。49株(75%)菌株携带有isa(C)基因,并表达了LASP表型;12株(18%)菌株携带有inu(B)和isa(E)基因,并表达LSAP表型。剩下的4个菌株对所检测的决定因素均表现为阴性。

研究结果表明,这些耐药表型出现的频率很低 (0.31%),但近年来出现的频率却是在增加。

原始出处:

Hawkins PA, Law CS, Metcalf BJ,et al.Cross-resistance to lincosamides, streptogramins A and pleuromutilins in Streptococcus agalactiae isolates from the USA.J Antimicrob Chemother. 2017 Mar 13. doi: 10.1093/jac/dkx077.

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