Distributions of Macrolide-Lincosamide-Streptogramin B Resistance Phenotypes in Clinical Isolates of Staphylococi
2
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
배경: 그람양성세균 감염에 macrolides 계열 약물을 폭넓게 사용함에 따라 임상검체에서 분리되는 포도알균의 macrolide- lincosamide-streptogramin B (MLSB) 항균제에 대한 내성률이 증가하게 되었다. 포도알균의 MLSB 내성 표현형의 비율 은 지역과 연구시기에 따라 차이가 있다. 본 연구에서는 일개 대학병원의 분리되는 포도알균의 MLSB 내성 표현형의 분포를 살펴보고자 하였다. 방법: 포도알균의 MLSB 내성 표현형은 erythromycin과 clindamycin 디스크를 이용한 이중디스크법을 이용하였다. 결과: 전체 7,916 포도알균 중에서 55.7%는 구성형 MLSB 내성이었고, 8.1%는 유도형 MLSB 내성이었다. 4,497 균주의 Staphylococcus aureus 중에서 구성형과 유도형 MLSB 내성률은 73.1%와 6.8%였고, 3,419 coagulase 음성 포도알균(CNS) 중에서 구성형과 유도형 MLSB 내성률은 32.6%와 10.0%였다. 구성형 MLSB 내성률은 methicillin-resistant S. aureus (MRSA) 90.2%, methicillin-resistant CNS (MRCNS) 46.5%, methicillin-susceptible CNS (MSCNS) 3.2% 및 methicillin-susceptible S. aureus (MSSA) 2.2%였다. 유도형 MLSB 내성률은 MSSA 16.5%, MRCNS 11.5%, MSCNS 6.7% 및 MRSA 4.4%였다. 결론: MLSB 내성은 CNS보다 S. aureus에서 흔하였다. 구성형 MLSB는 전체 포도알균 중에서 가장 흔히 검출되는 내성 표현형이며, methicillin 감수성 균주는 methicillin 내성 균주에 비해 유도형 MLSB 내성 표현형 비율이 다소 높았다.
Abstract
Background: Increased resistance rates to macrolide- lincosamide-streptogramin B (MLSB) antibiotics among clinical isolates of staphylococci are considered as a consequence of an expanded use of these antibiotics in the treatment of Gram-positive infections. The proportion of MLSB resistance phenotypes of staphylococci is quite different by geographical variations and study periods. The aim of the present study was to determine the distribution of MLSB resistance phenotypes among clinical isolates of staphylococci in a university hospital. Methods: The MLSB resistance phenotypes of clinical isolates of staphylococci were investigated by the double-disk diffusion test using erythromycin and clindamycin disks. Results: Of 7,916 isolates, 55.7% exhibited a constitutive resistance phenotype (cMLSB) whereas 8.1% expressed an inducible resistance phenotype (iMLSB). Among 3,419 coagulase-negative staphylococci (CNS), 32.6% and 10.0% exhibited cMLSB and iMLSB resistance phenotypes, respectively. Of 4,497 Staphylococcus aureus isolates, 73.1% and 6.8% were cMLSB and iMLSB resistance phenotypes, respectively. cMLSB was detected among 90.2% of methicillin-resistant S. aureus (MRSA), 46.5% of methicillin-resistant CNS (MRCNS), 3.2% of methicillin-susceptible CNS (MSCNS), and 2.2% of methicillin-susceptible S. aureus (MSSA). iMLSB was detected among 16.5% of MSSA, 11.5% of MRCNS, 6.7% of MSCNS, and 4.4% of MRSA. Conclusion: MLSB resistance was more prevalent among S. aureus isolates than CNS strains. Although cMLSB was the most frequently detected resistance phenotype among the total staphylococcal isolates, methicillin-susceptible strains exhibited somewhat higher iMLSB resistance rates compared with methicillin- resistant strains.
참고문헌 (16)
- Maltezou HC, "Community-acquired methicillin-resistant Staphylococcus aureus infections", Int J Antimicrob Agents, 27, pp.87~96 (2006)
- Lewis JS, "Inducible clindamycin resistance in staphylococci: should clinicians and microbiologists be concerned?", Clin Infect Dis, 40, pp.280~285 (2005)
- National Committee for Clinical Laboratory Standards, "Performance standards for antimicrobial susceptibility testing. fourteenth informational supplement", Wayne, PA;NCCLS, ~, pp.NCCLS document M100-S14 (2004)
- "Bacterial sensitivity test KB Disk Eiken operation manual" (2003), Eiken
- Lim JA, "Prevalence of resistance to macrolide, lincosamide and streptogramin antibiotics in Gram-positive cocci isolated in a Korean hospital", J Antimicrob Chemother, 49, pp.789~495 (2002)
- Nicola FG, "Characterization of erythromycin-resistant isolates of Staphylococcus aureus recovered in the United States from 1958 through 1969", Antimicrob Agents Chemother, 42, pp.3024~3027 (1998)
- Schmitz FJ, "Prevalence of resistance to MLS antibiotics in 20 European university hospitals participating in the European SENTRY surveillance programme. Sentry Participants Group", J Antimicrob Chemother, 43, pp.783~792 (1999)
- Chong Y, "New antimicrobial resistance and mech anisms of bacteria. 1st ed", pp.181~197 (2002), Seoheung Publishing Company
- LaPlante KL, "Activities of clindamycin, daptomycin, doxycycline, linezolid, trimethoprim- sulfamethoxazole, and vancomycin against community-associated methicillin-resistant Staphylococcus aureus with inducible clindamycin resistance in murine thigh infection and in vitro harmacodynamic models", Antimicrob Agents Chemother, 52, pp.2156~2162 (2008)
- Westh H, "Prevalence of erm gene classes in erythromycin-resistant Staphylococcus aureus strains isolated between 1959 and 1988", Antimicrob Agents Chemother, 39, pp.369~373 (1995)
- Thakker-Varia S, "Molecular epidemiology of macrolides-lincosamidesstreptogramin B resistance in Staphylococcus aureus and coagulase-negative staphylococci", Antimicrob Agents Chemother, 31, pp.735~743 (1987)
- Eady EA, "Distribution of genes encoding erythromycin ribosomal methylases and an erythromycin efflux pump in epidemiologically distinct groups of staphylococci", J Antimicrob Chemother, 31, pp.211~217 (1993)
- Cetin ES, "Macrolide-lincosamide-streptogramin B resistance phenotypes in clinical staphylococcal isolates", Int J Antimicrob Agents, 31, pp.364~368 (2008)
- 김재석, "국내 13개 의료기관에서 수집된 Staphylococcus aureus의 항균제 감수성 양상", 대한진단검사의학회지, 24(4), pp.223~229 (2004), 대한진단검사의학회
- Uh Y, "Antimicrobial agents and antimicrobial susceptibility test 1st ed", pp.556~557 (2007), Korean Studies Information Co., Ltd.