上海市嘉定地区感染患儿分离的化脓链球菌分子流行病学分析

doi:10.3969/j.issn.1673-8640.2016.12.011

检验医学 ›› 2016, Vol. 31 ›› Issue (12): 1061-1065.DOI: 10.3969/j.issn.1673-8640.2016.12.011

上海市嘉定地区感染患儿分离的化脓链球菌分子流行病学分析

乔丹¹, 陈明亮², 朱咏臻¹, 樊绮诗¹, 周敏¹

1. 上海交通大学医学院附属瑞金医院北院检验科,上海 201801
2. 上海市疾病预防控制中心,上海 200336

收稿日期:2016-02-15 出版日期:2016-12-25 发布日期:2016-12-29
作者简介:null
作者简介：乔丹,女,1984年生,博士,技师,主要从事病原微生物诊断和耐药研究。

通讯作者：周敏,联系电话：021-67888229。

Molecular epidemiological analysis of Streptococcus pyogenes isolated from children in Jiading,Shanghai

QIAO Dan¹, CHEN Mingliang², ZHU Yongzhen¹, FAN Qishi¹, ZHOU Min¹

1. Department of Clinical Laboratory,Ruijin Hospital（North）,Shanghai Jiaotong University School of Medicine,Shanghai 201801,China
2. Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China

Received:2016-02-15 Online:2016-12-25 Published:2016-12-29

摘要/Abstract

摘要：

目的了解上海市嘉定地区感染患儿分离的化脓链球菌emm分型及其耐药特点,为临床治疗和感染控制提供相关信息。方法收集2014年11月至2015年7月在上海交通大学医学院附属瑞金医院北院门诊就诊的急性上呼吸道感染、急性扁桃体炎、急性咽炎等患儿或带菌者咽拭子样本分离的化脓链球菌75株。应用API 20 Strep链球菌鉴定板条进行菌株鉴定,并用纸片扩散法检测菌株对8种常用抗菌药物的敏感性。应用聚合酶链反应（PCR）扩增编码M蛋白的emm基因,对PCR扩增后的emm基因产物进行测序,通过比对,获得菌株的emm分型结果。采用脉冲场凝胶电泳（PFGE）分析不同emm基因型菌株的特征,并将75株化脓链球菌结果导入BioNumerics软件进行聚类分析。结果上海市嘉定地区化脓链球菌对红霉素、克林霉素的耐药率分别为94.7%和97.3%,对红霉素和克林霉素的双重耐药率为93.3%。具有相同emm基因型的菌株在PFGE带型上高度聚集,其中存在占优势的PFGE型。在临床分离的75株化脓链球菌中,emm1基因型菌株25株（33.3%,25/75）,emm12基因型菌株49株（65.3%,49/75）,emm22基因型菌株仅1株（1.3%,1/75）。结论目前上海市嘉定地区儿童咽拭子样本分离得到的化脓链球菌对红霉素普遍耐药,且与克林霉素存在较严重的交叉耐药现象。emm12或emm1基因型菌株是上海市嘉定地区儿童主要感染的化脓链球菌类型。

关键词: 化脓链球菌, 红霉素, emm基因分型, 细菌, 耐药性

Abstract:

Objective To study the emm genotype in Streptococcus pyogenes isolated from children in Jiading,Shanghai and its drug resistance,and to provide a reference for infection control and treatment.Methods Outpatient children diagnosed with acute respiratory infection,acute tonsillitis and acute pharyngitis or carriers in Ruijin Hospital（North） from November 2014 to July 2015 were enrolled,and 75 isolates of Streptococcus pyogenes were collected by pharyngeal swab culture. The isolates ofStreptococcus pyogenes were identified by API 20 Strep. Antimicrobial susceptibility test was done by Kirby-Bauer method for 8 kinds of commonly-used antibiotics. The emm gene encoding M protein was amplified by polymerase chain reaction（PCR）,and the gene product of PCR was sequenced. Through comparison,the emm genotypes were obtained. The characteristics of different emm genotypes were analyzed by pulsed-field gel electrophoresis（PFGE）. BioNumerics software was used to analyze PFGE results from 75 isolates of Streptococcus pyogenes for cluster analysis. Results The erythromycin and clindamycin resistance rates of Streptococcus pyogenes in Jiading,Shanghai were 94.7% and 97.3%,respectively. The double resistance rate to erythromycin and clindamycin was 93.3%. The isolates with the same emm genotype in PFGE band were in high cluster. There were major PFGE genotypes. Among 75 isolates of Streptococcus pyogenes,25 isolates（33.3%,25/75） contained emm1 genotype,49 isolates（65.3%,49/75） contained emm12 genotype,and only 1 isolate（1.3%,1/75） contained emm22 genotype. Conclusions There is a high erythromycin resistance rate of Streptococcus pyogenes isolated from children in Jiading,Shanghai. The cross resistance with clindamycin is high. Streptococcus pyogenes containing emm12 or emm1 genotype is the main epidemic pathogen among children in Jiading,Shanghai.

Key words: Streptococcus pyogenes, Erythromycin, emm genotypes, Bacteria, Drug resistance

中图分类号:

R446.1

乔丹, 陈明亮, 朱咏臻, 樊绮诗, 周敏. 上海市嘉定地区感染患儿分离的化脓链球菌分子流行病学分析[J]. 检验医学, 2016, 31(12): 1061-1065.

QIAO Dan, CHEN Mingliang, ZHU Yongzhen, FAN Qishi, ZHOU Min. Molecular epidemiological analysis of Streptococcus pyogenes isolated from children in Jiading,Shanghai[J]. Laboratory Medicine, 2016, 31(12): 1061-1065.

图/表 1

参考文献 15

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上海市嘉定地区感染患儿分离的化脓链球菌分子流行病学分析

Molecular epidemiological analysis of Streptococcus pyogenes isolated from children in Jiading,Shanghai

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