Penicillin resistance profiles and pbp 2b gene polymorphisms in Streptococcus pneumoniae isolated from community outpatient clinic

• Main Author: 歐陽士平
• Other Authors: Chih-Ching Chang
• Format: Others
• Language: zh-TW
• Published: 2003
• Online Access: http://ndltd.ncl.edu.tw/handle/n2fydf

碩士 === 高雄醫學大學 === 公共衛生學研究所 === 91 === Objective: In recent years, antibiotic resistance has emerged as an important global problem. High level of antibiotic-resistant is found in Streptococcus pneumonia in Taiwan. To the best of our knowledge, the finding of penicillin resistance profiles in S. pneumonia isolated from community outpatient clinic has not been previously reported. Therefore the objective in this research is to assess the penicillin resistance of pneumococci from outpatients with upper respiratory tract infections and risk factors for carriage. Method: During November 2001 to March 2002 and December 2002 to January 2003, 151 isolates of S. pneumoniae were collected from outpatients with upper respiratory tract symptom in 6 clinics. The MIC of isolates were dertermined by E test. The pbp2b gene were amplified by PCR, and the products were digested with restriction enzymes RsaI and HaeⅢ. Results: The age is a major risk factor for carriage(P＜0.05). Penicillin-resistant S. pneumoniae (PRSP) rates were highest among persons aged ≦7 years. Of these isolates, 31.8% were penicillin nonsusceptible (MIC 0.12-1 μg/ml) and 20.5% were high-level resistant (MIC > 1 μg/ml). There were 9 PCR-RFLP profiles for pbp 2b gene. 83.9% of isolates with high-level resistant had PCR-RFLP type 3 or 6. Conclusion: There is high incidence of penicillin resistance among community isolates of S. pneumoniae in Taiwan. The surveillance of PRSP can help track community resistance problems and prevent the dissemination of S. pneumoniae. In the future, PFGE or DNA sequencing is needed to help define the clonal relationships of the isolates.