title: Drug Resistance Characteristics and Macrolide-Resistant Mechanisms of Streptococcus pneumoniae in Wenzhou City, China.
abstract: BACKGROUND Streptococcus pneumoniae (SP) is a Gram-positive, alpha-hemolytic, facultative anaerobic member of the genus Streptococcus. The erythromycin-resistant methylase (erm) gene and macrolide efflux (mef) gene are the 2 main genes that can mediate SP. Transposon (Tn) also plays an important role in the collection and metastasis of the gene. In the present study we investigated the drug resistance characteristics and the macrolide-resistant mechanisms of SP in Wenzhou City, China. MATERIAL AND METHODS Sixty-eight strains of SP were isolated from sputum samples of hospitalized children in the Second Affiliated Hospital of Wenzhou Medical University. These strains were analyzed using antimicrobial susceptibility tests to determine their drug resistance to 10 kinds of antibacterials. Macrolide-resistant phenotypes were identified using K-B method. PCR method was used to analyze the erm B gene, mef A gene, and int Tn gene. RESULTS Drug resistance rates of 68 strains of SP were 98.5%, 100.0%, 63.2%, 52.9%, 94.1%, 89.7%, 0.0%, 0.0%, 16.2%, and 14.7% for clindamycin, erythromycin, penicillin G, cefotaxime, tetracycline, sulfamethoxazole/trimethoprim, levofloxacin, vancomycin, chloramphenicol, and amoxicillin, respectively. Total detection rates of the erm B gene, mef A gene, and int Tn gene were 98.5%, 91.2%, and 100.0%, respectively. CONCLUSIONS SP shows significant multi-drug resistance in Wenzhou City, whereas there is no clinical value of macrolides antibiotics for SP. cMLSB mediated by erm B gene is the most predominant phenotype among macrolide-resistant SP. The int Tn gene may play an important role in horizontal transfer and clonal dissemination of SP drug resistance genes in Wenzhou City.
authors.affiliation: Department of Laboratory Medicine, Taizhou Municipal Hospital, Taizhou, Zhejiang, China (mainland).
authors.forename: Dakang
authors.initials: D
authors.lastname: Hu
authors.affiliation: Department of Clinical Laboratory, Shengli Oil Field Shengli Hospital, Dongying, Shandong, China (mainland).
authors.forename: Zheng
authors.initials: Z
authors.lastname: Sun
authors.affiliation: Department of Laboratory Medicine, Taizhou Municipal Hospital, Taizhou, Zhejiang, China (mainland).
authors.forename: Xinhua
authors.initials: X
authors.lastname: Luo
authors.affiliation: Department of Blood Transfusion, Taizhou Municipal Hospital, Taizhou, Zhejiang, China (mainland).
authors.forename: Shuangchun
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Laboratory Medicine, Taizhou Municipal Hospital, Taizhou, Zhejiang, China (mainland).
authors.forename: Lianhua
authors.initials: L
authors.lastname: Yu
authors.affiliation: Department of Laboratory Medicine, Taizhou Municipal Hospital, Taizhou, Zhejiang, China (mainland).
authors.forename: Ying
authors.initials: Y
authors.lastname: Qu
authors.affiliation: Department of Laboratory Medicine, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China (mainland).
authors.forename: Jinhong
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Laboratory Medicine, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China (mainland).
authors.forename: Jian
authors.initials: J
authors.lastname: Yu
authors.affiliation: Department of Laboratory Medicine, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China (mainland).
authors.forename: Xiangyang
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Laboratory Medicine, Taizhou Municipal Hospital, Taizhou, Zhejiang, China (mainland).
authors.forename: Jin
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D002681:China; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics; D005260:Female; D006801:Humans; D018942:Macrolides / Q000494:pharmacology; D008297:Male; D008565:Membrane Proteins / Q000235:genetics; D008780:Methyltransferases / Q000235:genetics; D008826:Microbial Sensitivity Tests; D011008:Pneumococcal Infections / Q000382:microbiology; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D018942:Macrolides; C431304:MefE protein, Streptococcus pneumoniae; D008565:Membrane Proteins; C111078:ErmTR protein, bacteria; D008780:Methyltransferases