由mef(a)-msr(D)/emm2-ST55谱系驱动的葡萄牙化脓性链球菌咽炎大环内酯类药物耐药性增加(2014-2019)

IF 4.5 2区 医学 Q2 MICROBIOLOGY
Ana Friães, Rafael Mamede, Beatriz Santos, Gina Marrão, José Melo-Cristino, Mario Ramirez
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引用次数: 0

摘要

最近在一些国家的化脓性链球菌(A群链球菌,GAS)中出现了大环内酯类药物耐药性的增加。虽然监测非侵袭性GAS的临床和分子流行病学的重要性日益被认识到,但大多数监测都集中在侵袭性感染上,因为扁桃体咽炎很少进行培养。我们确定了2014-2019年在葡萄牙一家医院回收的2002株咽部分离株的抗生素敏感性并对大环内酯耐药谱系进行了表征。分离株数量有季节性变化,高峰在3 - 7月和10 - 12月之间转移,但8月和9月的分离株数量一直较低。大环内酯耐药菌株和大环内酯敏感菌株表现出独立的季节和克隆动态,耐药菌株表现出较低的遗传多样性,与敏感谱系的重叠最小。总体而言,84株(4%)、77株(4%)和52株(3%)分别对红霉素、克林霉素和四环素耐药。直到2018年,大环内酯类药物耐药主要是由于ICESp2905中携带erm(A)和tet(O)的国际传播的emm77-ST63谱系和一种新的h 1207.3变体中携带mef(A)-msr(D)的emm75-ST49谱系。2019年,由于mef(A)-msr(D)阳性emm2-ST55分离株迅速扩增,取代了以前的菌株系,耐药性达到9%的峰值。其他次要抗性系在移动遗传元件多样性中主要携带erm(B),包括emm75-ST150、emm9-ST75、emm11-ST403、emm12-ST36、emm76-ST50和emm77-ST399 [erm(T)]。四环素耐药性与tet(M)和tet(O)基因有关,在大多数情况下与erm基因位于相同的遗传元件中。这项研究揭示了大环内酯类药物耐药GAS的克隆变化驱动大环内酯类药物耐药性和相关表型的波动。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Increase of macrolide resistance among Streptococcus pyogenes pharyngitis driven by a mef(A)-msr(D)/emm2-ST55 lineage in Portugal (2014-2019).

Increases in macrolide resistance occurred recently among Streptococcus pyogenes (Group A Streptococcus, GAS) in some countries. While the importance of monitoring the clinical and molecular epidemiology of non-invasive GAS is increasingly recognized, most surveillance focuses on invasive infections, since culture is rarely performed in tonsillo-pharyngitis. We determined the antimicrobial susceptibility and characterized the macrolide-resistant lineages of 2,002 pharyngeal isolates recovered in a Portuguese hospital in 2014-2019. There were seasonal variations in the numbers of recovered isolates, with peaks shifting between March-July and October-December, but consistently low numbers in August and September. Macrolide-resistant and macrolide-susceptible GAS presented independent seasonal and clonal dynamics, with resistant isolates showing lower genetic diversity and minimal overlap with susceptible lineages. Overall, 84 (4%), 77 (4%), and 52 (3%) isolates were resistant to erythromycin, clindamycin, and tetracycline, respectively. Until 2018, macrolide resistance was mainly due to an internationally disseminated emm77-ST63 lineage carrying erm(A) and tet(O) in ICESp2905 and an emm75-ST49 lineage carrying mef(A)-msr(D) in a novel ɸ1207.3 variant. In 2019, resistance peaked at 9% due to the rapid expansion of mef(A)-msr(D)-positive emm2-ST55 isolates, replacing previous lineages. Other minor resistant lineages carried mostly erm(B) in a diversity of mobile genetic elements, including emm75-ST150, emm9-ST75, emm11-ST403, emm12-ST36, emm76-ST50, and emm77-ST399 [erm(T)]. Tetracycline resistance was associated with the genes tet(M) and tet(O), in most cases co-located in the same genetic elements as the erm genes. This study reveals clonal changes among macrolide-resistant GAS driving fluctuations in macrolide resistance and associated phenotypes.

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来源期刊
CiteScore
10.00
自引率
8.20%
发文量
762
审稿时长
3 months
期刊介绍: Antimicrobial Agents and Chemotherapy (AAC) features interdisciplinary studies that build our understanding of the underlying mechanisms and therapeutic applications of antimicrobial and antiparasitic agents and chemotherapy.
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