肖士林, 贾雪洋, 聂旭冬, 秦天, 任红宇. 101株军团菌耐药谱分析[J]. 疾病监测, 2019, 34(10): 928-931. DOI: 10.3784/j.issn.1003-9961.2019.10.015
引用本文: 肖士林, 贾雪洋, 聂旭冬, 秦天, 任红宇. 101株军团菌耐药谱分析[J]. 疾病监测, 2019, 34(10): 928-931. DOI: 10.3784/j.issn.1003-9961.2019.10.015
Shilin Xiao, Xueyang Jia, Xudong Nie, Tian Qin, Hongyu Ren. Antibiotic resistance of 101 Legionella strains[J]. Disease Surveillance, 2019, 34(10): 928-931. DOI: 10.3784/j.issn.1003-9961.2019.10.015
Citation: Shilin Xiao, Xueyang Jia, Xudong Nie, Tian Qin, Hongyu Ren. Antibiotic resistance of 101 Legionella strains[J]. Disease Surveillance, 2019, 34(10): 928-931. DOI: 10.3784/j.issn.1003-9961.2019.10.015

101株军团菌耐药谱分析

Antibiotic resistance of 101 Legionella strains

  • 摘要:
    目的了解不同来源、不同血清型/群军团菌菌株耐药性情况。
    方法采用E-test试纸条法对101株17个血清型的军团菌(包括67株环境分离菌株,16株临床分离菌株以及18株国际参考菌株)进行红霉素、利福平、左氧氟沙星、舒巴坦、阿奇霉素、莫西沙星和头孢呋辛7种抗生素药敏实验。
    结果所有实验菌株中只有3株未出现耐药情况。 其余98株菌株对7种抗生素均有不同程度的耐药。 对头孢呋辛耐药率为69.31%(n=70),阿奇霉素耐药率为8.91%(n=9),莫西沙星耐药率为7.92%(n=8),利福平耐药率为5.94%(n=6),舒巴坦耐药率为4.95%(n=5),红霉素耐药率为2.97%(n=3),左氧氟沙星耐药率为0.99%(n=1)。 17个血清型中,13个血清型对头孢呋辛耐药,4个血清型出现耐多药(≥2种抗生素)。 嗜肺军团菌血清(LP)4型对舒巴坦和头孢呋辛2种抗生素同时耐药,LP5型对头孢呋辛和莫西沙星2种抗生素同时耐药,LP9型对红霉素、舒巴坦和头孢呋辛3种抗生素同时耐药,LP1型对红霉素、阿奇霉素、左氧氟沙星、莫西沙星、利福平、舒巴坦和头孢呋辛7种抗生素同时耐药;其余9个血清型只对头孢呋辛耐药。 非嗜肺军团菌血清型(L. oakridgensi)仅对阿奇霉素和头孢呋辛耐药,而血清型LP3、博兹蔓军团菌(Legionella bozemanii)和菲氏军团菌(L. feeleii)对所有抗生素均敏感。
    结论临床上用于治疗军团菌病的一线抗生素如红霉素仍然可以作为首选药物。 此外奎诺酮类抗生素左氧氟沙星在治疗军团菌病时也可作为备选。 耐药最为严重的头孢呋辛不能用于治疗军团菌病。

     

    Abstract:
    ObjectiveTo investigate the drug resistance of Legionella from different sources and serotypes/groups.
    MethodsAntibiotic susceptibility tests of Legionella to erythromycin, rifampicin, levofloxacin, sulbactam, azithromycin, moxifloxacin and cefuroxime were carried out by using 101 Legionella strains, including 67 environmental isolates, 16 clinical isolates and 18 international reference strains, in 17 serotypes.
    ResultsOnly three of the strains showed no antibiotic resistance. The other 98 strains were resistant to seven antibiotics at different degrees. The resistance rate was 69.31% to cefuroxime (n=70), 8.91% to azithromycin (n=9), 7.92% to moxifloxacin (n=8), 5.94% to rifampicin (n=6), 4.95% to sulbactam (n=5), 2.97% to erythromycin (n=3), and 0.99% to levofloxacin (n=1). Among the 17 serotypes, 13 serotypes were found to be resistant to cefuroxime, and 4 serotypes were multi-drug resistant (≥ 2 antibiotics). The serotype of simultaneous resistant to sulbactam and cefuroxime was LP4; the serotype of simultaneous resistant to cefuroxime and moxifloxacin was LP5; the serotype of simultaneous resistant to erythromycin, sulbactam and cefuroxime was LP9; and the serotype of simultaneous resistant to erythromycin, azithromycin, levofloxacin, moxifloxacin, rifampicin, sulbactam and cefuroxime was LP1. The remaining 9 serotypes were only resistant to cefuroxime. In addition, two non-L. pneumophila serotypes (L. oakridgensi) were only resistant to azithromycin. LP3, L. feeleii and L. bozemanii were sensitive to all antibiotics.
    ConclusionErythromycin, a first-line antibiotic for legionellosis, could still be used as the first choice in clinical treatment. In addition, quinolone antibiotic levofloxacin can also be used as an alternative in the treatment of legionellosis. Cefuroxime, which is the most resistant drug, should be avoided to use in the treatment of legionellosis.

     

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