Detection of erm genes and epidemiology research of Staphylococcus aureus in patients with bloodstream infection

doi:10.3969/j.issn.1673-8640.2013.03.005

Abstract

Abstract: Objective　To investigate the distribution and epidemic situation of erythromycin ribosome methylase（erm）genes in erythromycin-resistant Staphylococcus aureus in patients with bloodstream infection from January 2006 to August 2011. Methods　A total of 39 isolates of erythromycin-resistant Staphylococcus aureus were collected from January 2006 to August 2011 among patients with bloodstream infection. The bacterium identification and antimicrobial susceptibility test were conducted by VITEK 2 Compact automatic system，matched identification card and antimicrobial susceptibility card. Methicillin-resistant Staphylococcus aureus (MRSA) was identified by disk diffusion method with cefoxitin. Phenotypic expression of inducible resistance was assessed by D test. Polymerase chain reaction (PCR) was used to detect ermA，ermB and ermC genes. The epidemic situation of ermA-producing Staphylococcus aureus was analyzed by pulsed-field gel electrophoresis (PFGE) and Staphylococcal cassette chromosome mec(SCCmec)typing. Results　The resistant rates of 39 erythromycin-resistant Staphylococcus aureus to clindamycin，penicillin and gentamicin were high，and were 100.0%，92.3% and 53.8%，respectively. A total of 8(20.5%) isolates of Staphylococcus aureus with discordant resistance pattern (erythromycin resistant and clindamycin sensitive) were all positive in D test. The positive rates of ermA，ermB and ermC were 25.6%（10/39），46.2%（18/39） and 46.2%（18/39），respectively. A total of 75.0% (6/8) and 25.0% (2/8) isolates with phenotypic expression of inducible resistance by D test harbored ermC and ermA genes. PFGE analysis of the all 10 MRSA isolates harboring ermA gene produced 6 distinct pulsotypes，8 MRSA isolates were SCCmecⅢ genotype，and 2 MRSA isolates could not be determined by SCCmec typing. Conclusions　The positive rate of erm genes in erythromycin-resistant Staphylococcus aureus in patients with bloodstream infection is relatively high. The ermA and ermB genes are mainly harbored by MRSA and methicillin-sensitive Staphylococcus aureus(MSSA)，respectively. The isolates with erythromycin inducible to clindamycin resistance mainly harbored ermC gene. A total of 10 isolates harboring ermA gene are all MRSA ，and are multidrug-resistant .There is scattered cloning spread of MRSA belonging to SCCmecⅢ genotype with ermA gene.

Key words: Erythromycin ribosome methylase gene, Staphylococcus aureus, Bloodstream infection, Erythromycin, Clindamycin

WANG Lixin 1，HU Yiming 2，HU Zhidong 1，TIAN Bin 1，LI Jing 1，WANG Fengxia 1，YANG Hua 1. Detection of erm genes and epidemiology research of Staphylococcus aureus in patients with bloodstream infection[J]. , 2013, 28(3): 189-193.

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