摘要目的 研究婴幼儿眼部感染肺炎链球菌的群体结构,包括对抗菌药物的耐药性、耐药基因、血清型和分子分型.方法 用K-B法和Etest检测39株肺炎链球菌对10种抗菌药物的耐药性,乳胶凝集试验检测血清型,PCR法检测大环内酯类药物耐药基因mefE和ermB,并选择20株菌株进行多位点序列(MLST)分型.结果 39株肺炎链球菌中,30株(76.9％)对3种或3种以上药物耐药,未检测到对万古霉素、青霉素和头孢噻肟耐药的菌株.33株检出ermB耐药基因,4株检出mefE基因.共检出12种血清型,主要为19型( 8/39)和14型(4/39),17株包含在PCV7疫苗内,疫苗覆盖率为43.6％.MLST分型发现国际耐药克隆Taiwan19F-14和Spain23F-1.结论婴幼儿眼部感染的肺炎链球菌包含国际流行耐药克隆,血清型和分子分型较为分散,克隆分布以散发为主,对眼部常用抗菌药物有较高的耐药性.

abstractsObjective To determine the population structure of Streptococcus pncumoniae isolates collected from infants with eye infections,including drug resistance,resistance genes, serotypes and molecular types.Methods The susceptibility of 39 isolates to 10 antibacterial agents was tested by K-B disk diffusion and Etest.Latex agglutination test was performed to determine the serotype of the strains,and PCR was carried out to detect macrolides resistance genes mefE and ermB.Molecular types of the 20 strains were determined by multilocus sequence typing (MLST).Results A total of 39 Streptococcus pneumoniae isolates were obtained,in which 30 (76.9％) were resistant to 3 or more antibacterial agents,and no vancomycin,penicillin or cefotaxime resistant strain was found.ermB gene was found in 33 strains and mefE gene was found in 4 strains.Twelve serotypes were found,and the most frequent serotypes were 19 (8/39) and 14 (4/39). Seventeen strains (43.6％) were covered in PCV7 vaccine. The international clone Taiwan19F-14 and Spain23F-1 were found by MLST. Conclusions Streptococcus pneumoniae isolates from infants with eye infections include international resistance clones.The distribution of serotype and molecular type are dispersed, and the clones are sporadic. The isolates are highly resistant to commonly used antibacterial agents.