无乳链球菌临床株对四环素类的敏感性研究

为探讨无乳链球菌对四环素类的敏感性及其与耐药基因、多位点序列分型(multilocus sequence typing,MLST)之间的关系,本研究收集2014-2017年深圳市南山区人民医院分离自患者的136株无乳链球菌临床分离株,采用琼脂平板稀释法分析四环素类最低抑菌浓度(minimum inhibitory concentration,MIC)。采用聚合酶链反应检测菌株四环素类耐药基因(tetM、tetK、tetO),MLST测定ST型别,并分析四环素类敏感性与其耐药基因及ST型别之间的关系。结果显示,无乳链球菌对四环素类的耐药率为46.32%,耐四环素类菌株主要携带tetM基因,主要为ST17型和ST19型,且ST17型菌株对四环素类的耐药率显著高于ST19型(P<0.05)。结果提示,无乳链球菌的主要四环素类耐药基因为tetM,ST17型、ST19型是主要流行型别,且ST17型菌株对四环素类的敏感性低于ST19型。     

光唇鱼源无乳链球菌的分离鉴定及遗传特征

【目的】为查明浙江养殖光唇鱼大量死亡的病原,了解病原的遗传特征。【方法】本工作对患病光唇鱼进行病原分离,结合形态特征、生理生化特性和16S rRNA基因序列同源性,对分离菌株进行鉴定;采用人工回感试验确定其病原性,并对分离株的血清型、多位点序列分型(multilocus sequence typing,MLST)、毒力基因型和表面蛋白抗原基因型等遗传特征进行分析;此外,还测试了菌株的药敏特性。【结果】从患病光唇鱼体中分离得到优势菌株ACRO-0708,为革兰氏阳性球菌,不溶血,分子与生化鉴定为无乳链球菌(Streptococcus agalactiae);人工感染试验证实其对光唇鱼有较强的致病性,LD50为6.47×10~3CFU/g,属于血清型Ⅰb和MLST型ST261,毒力基因型为sip~+bibA~+cfb~+hylB~+iagA~+fbsA~+fbsB~+bac~–bca~–cylE~–scpB~–lmb~–,不携带所检测的6种表面蛋白基因。药敏试验结果显示,对青霉素、氨苄西林等8种药物较敏感,对氯霉素、复方新诺明等7种药物耐药。【结论】引起浙江养殖光唇鱼死亡的病原菌为无乳链球菌,其分子特征与水产动物主要流行的无乳链球菌株具有显著差异,生产中可选用氨苄西林、氟苯尼考等药物进行防治。     

广东与海南养殖罗非鱼无乳链球菌的分离、鉴定与特性分析

从中国广东、海南罗非鱼主养区发生爆发性疾病的多个养殖场的罗非鱼病鱼体上,分离到多株致病菌株。人工感染试验显示分离菌株具有较强的致病力,有多株经腹部注射分离细菌浓度为1×106CFU/mL时可使100%的受感染鱼死亡,选择其中7株强毒株进行药物敏感性实验与鉴定。不同菌株对药物敏感性存在一定的差异但与菌株来源无相关性,29种抗生素中对13种敏感、7种不敏感、9种存在菌株的差异。各分离菌株均为革兰氏阳性菌,呈β溶血。采用链球菌快速鉴定系统ID32STREP、Lancefield分析及多项补充生理生化鉴定结果,初步判断为无乳链球菌Streptococcus agalactiae。PCR扩增16S rRNA基因和GBS-specific gene cfb(CAMP factor)基因的全长序列,BLAST分析显示所有菌株的16S rRNA基因与GenBank上登录的无乳链球菌的相应序列高度同源(99.8%),各分离菌株间的16S rRNA基因序列也高度同源(≥99.9%?100%)。各菌株cfb基因序列高度同源(100%),BLAST显示与已知无乳链球菌的相应序列也具有高度同源性(≥99.0%)。综合上述实验结果,可判定广东与海南罗非鱼主养区2009年夏季发生的罗非鱼爆发性疾病的病原菌为无乳链球菌。     

小儿下呼吸道感染痰培养标本病原菌构成分析

目的了解小儿下呼吸道感染病原菌的分布及对常用抗菌药物的耐药状况。方法对2710例小儿下呼吸道感染患者痰标本进行培养,用VITEK-2Compact微生物鉴定系统鉴定菌种和药敏试验,WHO-NET5．4软件对数据进行分析。结果共分离病原菌675株,革兰阴性杆菌457株,占67．7％,主要为大肠埃希菌、肺炎克雷伯菌;革兰阳性球菌159株,占23．5％,主要为金黄色葡萄球菌、肺炎链球菌;真菌59株,占8．7％,主要为白色假丝酵母菌。结论小儿下呼吸道感染病原菌以革兰阴性杆菌为主,耐药性较为严重,应不断加强耐药性监测,合理使用抗菌药物。     

儿童感染青霉素耐药肺炎链球菌的 多位点序列分型

目的对儿童感染的青霉素耐药肺炎链球菌进行多位点序列分型,了解厦门地区肺炎链球菌青霉素耐药菌株遗传背景。方法采用多位点序列分型法对2012年1月至2014年12月期间分离的60株青霉素耐药肺炎链球菌进行分子分型。结果 60株青霉素耐药肺炎链球菌MLST法共检出24个ST型,其中发现6个新的ST型,分别被命名为ST10004、ST10005、ST10006、ST10007、ST10008和ST10009。存在一个优势型别ST271,占31.7%(19/60),发现了4个克隆群和20种单一克隆,其中主要克隆群为国际流行耐药克隆群Taiwan19F-14,占41.7%(25/60)。结论本地区分离的儿童青霉素耐药肺炎链球菌主要以ST271型为主,属国际流行耐药克隆群Taiwan19F-14,是引起儿童呼吸道感染肺炎链球菌多重耐药的主要原因。     

临沂市奶牛乳房炎病原菌的分离鉴定与药敏试验

目的为弄清临沂市奶牛乳房炎主要病原菌种类及其药物敏感情况,为科学防治本病提供依据。方法采集患乳房炎奶牛的乳样进行细菌分离鉴定,并对主要病原菌做药敏试验。结果从115份乳样中,分离出6种127株病原菌,其中金黄色葡萄球菌46株,占36.22%,无乳链球菌33株,占25.98%,停乳链球菌21株,占16.53%,大肠埃希菌17株,占13.39%,乳房链球菌8株,占6.3%,沙门菌2株,占1.57%;主要病原菌均对头孢喹诺和左氧氟沙星高度敏感。结论临沂市奶牛乳房炎主要致病菌为金黄色葡萄球菌、链球菌和大肠埃希菌。首选药物为头孢喹诺和左氧氟沙星。因此,治疗奶牛乳房炎应通过药敏试验,合理地选择药物。     

无乳链球菌的研究进展

无乳链球菌亦称B群链球菌（Group B streptococcus,GBS）,一直是新生儿和女性生殖道受感染的重要病菌,尤其是新生儿时期的感染是危及生命的重要原因,其病发症包括败血症、肺炎和脑膜炎等。在成年妇女的阴道和直肠内有15％～40％可以检出无乳链球菌,因此,这类女性所分娩的新生儿感染该菌的机率会比较高。     

新生儿无乳链球菌分离株全基因组重测序分析

无乳链球菌是新生儿细菌感染的主要病原菌之一,严重危害新生儿的健康。目前,国内鲜有从基因组的角度对无乳链球菌进行深入研究。本研究对一株新生儿无乳链球菌分离株SA1507进行了全基因组重测序和生物信息学分析。与参考基因组进行比对,SA1507存在大量的变异位点,比对发现SNP 8 850个,大多数位于外显子区域;Indel 253个,大多数位于基因上游。对SNP和Indel进行COG聚类分析和KEGG通路分析,分别得到2 272个COG功能条目和1 363个KEGG通路条目。测序与分析将为进一步研究无乳链球菌的变异,感染和耐药性等奠定基础。     

82例极低/超低出生体重儿败血症的临床分析

目的:分析极低/超低出生体重儿败血症的临床特征、病原菌及药物敏感情况,为其早期诊断及治疗提供参考。方法:对2014年1月1日至2017年12月31日阜阳市人民医院新生儿重症监护病房(NICU)确诊的82例早产极低/超低出生体重儿败血症的临床表现、实验室检查、病原菌及药敏情况进行回顾性分析。结果:极低/超低出生体重儿败血症以早发型(≤7天)为主,晚发型以院内感染为主,临床表现缺乏特异性,实验室检查中白细胞、血小板出现减低,C反应蛋白和降钙素原增高。病原菌以革兰阴性菌为主,其次为革兰阳性菌和真菌。药敏结果显示革兰阴性菌对三代头孢、氨苄西林类抗生素100%耐药,对加他唑巴坦的抗生素耐药率较低,对碳氢酶烯类抗生素敏感。革兰阳性菌对β-内酰胺类、大环内酯类、氨基糖甙类及克林霉素等耐药率较高,对万古霉素、利奈唑烷敏感。82例败血症患儿中,死亡6例,死亡率为7.3%。结论:早产极低/超低出生体重儿败血症缺乏特异性临床表现,且发病率高,应密切观察患儿临床表现及动态监测其C反应蛋白、血小板等的变化,同时及时完善细菌培养及药敏试验,有效合理使用抗生素,以减少多重耐药菌株产生,改善患儿预后。     

广州地区儿童血培养病原菌的分布及耐药性研究

目的探讨儿童血培养病原菌的分布特点及其耐药情况,为临床诊疗提供参考。方法对广州市儿童医院2005年至2006年临床各科室送检血液标本所分离病原菌的分布及药敏结果进行回顾性分析。结果共检出385株病原菌,其中革兰阳性菌208株,占54．0％,革兰阴性菌164株,占42．6％,真菌13株,占3．4％。分离率前6位的病原菌依次为凝固酶阴性葡萄球菌（CNS,35．8％）、肺炎克雷伯菌（8．8％）、不动杆菌（5．5％）、大肠埃希菌（4．9％）、铜绿假单胞菌（4、7％）、金黄色葡萄球菌（4．4％）。病原菌的病区分布特点：儿科重症监护病房以不动杆菌等非发酵菌为主要分离菌（占41．7％）,新生儿重症监护病房以CNS为主（40．5％）,血液病区以肠杆菌科细菌为主（35．7％）,新生儿病房及传染病房均以CNS为主要分离菌。CNS对青霉素、氨苄西林、红霉素耐药率均超过80％,但对万古霉素、替考拉宁和阿米卡星敏感,MRCNS检出率达72.5％。肠杆菌科细菌对哌拉西林、氨苄西林、头孢噻肟及头孢哌酮的耐药率为50％～100％,但对亚胺培南、阿米卡星和诺氟沙星耐药率较低。不动杆菌对广谱青霉素、第3代头孢菌素、氨曲南及庆大霉素的耐药率较高而对亚胺培南、头孢哌酮／舒巴坦较为敏感。结论凝固酶阴性葡萄球菌是广州地区儿童败血症最主要的病原菌。不同病区检出病原菌种类有较大差异。根据病原菌种类及药敏结果合理应用抗菌药是有效控制感染和减少耐药菌株产生的重要手段。     

糖尿病患者无乳链球菌尿路感染临床表现及药物敏感性分析

目的了解糖尿病患者无乳链球菌尿路感染的临床表现及耐药状况,为临床用药提供依据。方法回顾性分析温州医学院附属第一医院2003年至2005年糖尿病患者继发尿路感染的临床特点及耐药情况。结果280例送检尿培养的住院糖尿病患者致病菌阳性有169例,共检出无乳链球菌25株,其中女性23例,男性2例。药敏结果显示无乳链球菌对氨曲南、林可霉素、复方新诺明、红霉素、阿米卡星的耐药率高达50%以上,而对头孢唑啉、万古霉素的耐药率为0%,对替考拉宁、青霉素、氨苄西林的耐药率为5.88%、7.69%、10%。结论糖尿病患者无乳链球菌引起尿路感染应引起注意,临床医生需根据药敏结果合理选用抗生素。     

Multilocus sequence-typing for characterization of Moscow strains of Haemophilus influenzae type b

Haemophilius influenzae, type b (Hib) bacteria, were genotyped by multilocus sequence typing (MLST) using 5 loci (adk, fucK, mdh, pgi, recA). 42 Moscow Hib strains (including 38 isolates form cerebrospinal fluid of children, who had purulent meningitis in 1999-2001, and 4 strains isolated from healthy carriers of Hib), as well as 2 strains from Yekaterinburg were studied. In MLST a strain is characterized, by alleles and their combinations (an allele profile) referred to also as sequence-type (ST). 9 Sts were identified within the Russian Hib bacteria: ST-1 was found in 25 strains (57%), ST-12 was found in 8 strains (18%), ST-11 was found in 4 strains (9%) and ST-15 was found in 2 strains (4.5%); all other STs strains (13, 14, 16, 17, 51) were found in isolated cases (2.3%). A comparison of allelic profiles and of nucleotide sequences showed that 93% of Russian isolates, i.e. strain with ST-1, 11, 12, 13, 15 and 17, belong to one and the same clonal complex. 2 isolates from Norway and Sweden from among 7 foreign Hib strains studied up to now can be described as belonging to the same clonal complex; 5 Hib strains were different from the Russian ones.     

Identification of genes and genomic islands correlated with high pathogenicity in Streptococcus suis using whole genome tiling microarrays

Streptococcus suis is an important zoonotic pathogen that can cause meningitis and sepsis in both pigs and humans. Infections in humans have been sporadic worldwide but two severe outbreaks occurred in China in recent years, while infections in pigs are a major problem in the swine industry. Some S. suis strains are more pathogenic than others with 2 sequence types (ST), ST1 and ST7, being well recognized as highly pathogenic. We analyzed 31 isolates from 23 serotypes and 25 STs by NimbleGen tiling microarray using the genome of a high pathogenicity (HP) ST1 strain, GZ1, as reference and a new algorithm to detect gene content difference. The number of genes absent in a strain ranged from 49 to 225 with a total of 632 genes absent in at least one strain, while 1346 genes were found to be invariably present in all strains as the core genome of S. suis, accounting for 68% of the GZ1 genome. The majority of genes are located in chromosomal blocks with two or more contiguous genes. Sixty two blocks are absent in two or more strains and defined as regions of difference (RDs), among which 26 are putative genomic islands (GIs). Clustering and statistical analyses revealed that 8 RDs including 6 putative GIs and 21 genes within these RDs are significantly associated with HP. Three RDs encode known virulence related factors including the extracellular factor, the capsular polysaccharide and a SrtF pilus. The strains were divided into 5 groups based on population genetic analysis of multilocus sequence typing data and the distribution of the RDs among the groups revealed gain and loss of RDs in different groups. Our study elucidated the gene content diversity of S. suis and identified genes that potentially promote HP.     

Prevalence of avian-pathogenic Escherichia coli strain O1 genomic islands among extraintestinal and commensal E. coli isolates

Escherichia coli strains that cause disease outside the intestine are known as extraintestinal pathogenic E. coli (ExPEC) and include pathogens of humans and animals. Previously, the genome of avian-pathogenic E. coli (APEC) O1:K1:H7 strain O1, from ST95, was sequenced and compared to those of several other E. coli strains, identifying 43 genomic islands. Here, the genomic islands of APEC O1 were compared to those of other sequenced E. coli strains, and the distribution of 81 genes belonging to 12 APEC O1 genomic islands among 828 human and avian ExPEC and commensal E. coli isolates was determined. Multiple islands were highly prevalent among isolates belonging to the O1 and O18 serogroups within phylogenetic group B2, which are implicated in human neonatal meningitis. Because of the extensive genomic similarities between APEC O1 and other human ExPEC strains belonging to the ST95 phylogenetic lineage, its ability to cause disease in a rat model of sepsis and meningitis was assessed. Unlike other ST95 lineage strains, APEC O1 was unable to cause bacteremia or meningitis in the neonatal rat model and was significantly less virulent than uropathogenic E. coli (UPEC) CFT073 in a mouse sepsis model, despite carrying multiple neonatal meningitis E. coli (NMEC) virulence factors and belonging to the ST95 phylogenetic lineage. These results suggest that host adaptation or genome modifications have occurred either in APEC O1 or in highly virulent ExPEC isolates, resulting in differences in pathogenicity. Overall, the genomic islands examined provide targets for further discrimination of the different ExPEC subpathotypes, serogroups, phylogenetic types, and sequence types.     

Streptococcus Suis Isolated from Pigs in Finland

A total of 58 Streptococcus suis strains were isolated from deceased pigs submitted to the National Veterinary Institute, Regional Laboratory in Kuopio, Finland, over a 3 1/2 year period, most frequently from cases of pneumonia. The bacteria were isolated from cases of meningitis, sepsis, rhinitis, endocarditis and abortion. S. suis was also isolated from nasal cavity, lung and brain of some sick piglets without signs of inflammation. Further S. suis was detected in 12 out of 107 tonsils of healthy fatteners tested. S. suis strains were identified by biochemical methods followed by typing. The most common capsular types were 7, 3 and 2, respectively. Only one type 1 strain and no types 6 and 9 strains were found. All S. suis strains tested were sensitive to penicillin and ampicillin. S. suis is not uncommon in Finnish pig herds. S. suis may be regarded as a potentially pathogenic organism which under certain predisposing conditions may cause serious disease.     

Nosocomial meningitis in neonates caused by Streptococcus agalactiae

Streptococcus agalactiae is a rare cause of neonatal meningitis in the era of peripartum prophylaxis with prophylaxis with ampicillin in colonized/infected mothers. However 5 cases of meningitis among 171 cases of pediatric nosocomial meningitis database within last 15 years occurred. All 5 children were neonates (one VLBW and early gestation newborn), 2 after neurosurgery. All 5 cases were successfully cured with a combination of cefotaxim (or ceftazidim) plus aminoglycosides, in one case also with addition of vancomycin or ampicillin. However 3 of 5 cured patients had neurologic sequellae, two of them reversible hydrocephalus and in speech retardation.     

Identification of Genes and Genomic Islands Correlated with High Pathogenicity in Streptococcus suis Using Whole Genome Tilling Microarrays

Streptococcus suis is an important zoonotic pathogen that can cause meningitis and sepsis in both pigs and humans. Infections in humans have been sporadic worldwide but two severe outbreaks occurred in China in recent years, while infections in pigs are a major problem in the swine industry. Some S. suis strains are more pathogenic than others with 2 sequence types (ST), ST1 and ST7, being well recognized as highly pathogenic. We analyzed 31 isolates from 23 serotypes and 25 STs by NimbleGen tiling microarray using the genome of a high pathogenicity (HP) ST1 strain, GZ1, as reference and a new algorithm to detect gene content difference. The number of genes absent in a strain ranged from 49 to 225 with a total of 632 genes absent in at least one strain, while 1346 genes were found to be invariably present in all strains as the core genome of S. suis, accounting for 68% of the GZ1 genome. The majority of genes are located in chromosomal blocks with two or more contiguous genes. Sixty two blocks are absent in two or more strains and defined as regions of difference (RDs), among which 26 are putative genomic islands (GIs). Clustering and statistical analyses revealed that 8 RDs including 6 putative GIs and 21 genes within these RDs are significantly associated with HP. Three RDs encode known virulence related factors including the extracellular factor, the capsular polysaccharide and a SrtF pilus. The strains were divided into 5 groups based on population genetic analysis of multilocus sequence typing data and the distribution of the RDs among the groups revealed gain and loss of RDs in different groups. Our study elucidated the gene content diversity of S. suis and identified genes that potentially promote HP.     

Complex Population Structure and Virulence Differences among Serotype 2 Streptococcus suis Strains Belonging to Sequence Type 28

Streptococcus suis is a major swine pathogen and a zoonotic agent. Serotype 2 strains are the most frequently associated with disease. However, not all serotype 2 lineages are considered virulent. Indeed, sequence type (ST) 28 serotype 2 S. suis strains have been described as a homogeneous group of low virulence. However, ST28 strains are often isolated from diseased swine in some countries, and at least four human ST28 cases have been reported. Here, we used whole-genome sequencing and animal infection models to test the hypothesis that the ST28 lineage comprises strains of different genetic backgrounds and different virulence. We used 50 S. suis ST28 strains isolated in Canada, the United States and Japan from diseased pigs, and one ST28 strain from a human case isolated in Thailand. We report a complex population structure among the 51 ST28 strains. Diversity resulted from variable gene content, recombination events and numerous genome-wide polymorphisms not attributable to recombination. Phylogenetic analysis using core genome single-nucleotide polymorphisms revealed four discrete clades with strong geographic structure, and a fifth clade formed by US, Thai and Japanese strains. When tested in experimental animal models, strains from this latter clade were significantly more virulent than a Canadian ST28 reference strain, and a closely related Canadian strain. Our results highlight the limitations of MLST for both phylogenetic analysis and virulence prediction and raise concerns about the possible emergence of ST28 strains in human clinical cases.     

Genetic analysis of Streptococcus agalactiae strains isolated from neonates and their mothers

Streptococcus agalactiae or group B streptococcus (GBS) is the most common cause of neonatal sepsis and meningitis in neonates. One of the major questions is whether the GBS strains able to cause neonatal invasive disease have peculiar genetic features. A collection of S. agalactiae strains, isolated from cervix, vagina and rectum of 10 mothers and from throat, ear and umbilicus of their newborns was genetically characterized by pulsed-field gel electrophoresis (PFGE). This study demonstrated that the strains isolated from each mother and her child were all genetically identical but that the strains from the 10 mother/child pairs mutually were genetically heterogeneous and 10 different PFGE patterns were found. Although it has been suggested that PFGE would be able to identify virulence traits to direct decisions in antibiotic management, the heterogeneous feature of GBS strains does not support broad application.