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首页> 外文期刊>Journal of Clinical Microbiology >Pneumococci Can Persistently Colonize Adult Patients with Chronic Respiratory Disease
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Pneumococci Can Persistently Colonize Adult Patients with Chronic Respiratory Disease

机译：肺炎球菌可以持久地定居于患有慢性呼吸系统疾病的成年患者

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Streptococcus pneumoniae plays an important role in causing acute exacerbations in patients with chronic respiratory disease. However, few data are available regarding pneumococcal persistence in adult patients with chronic respiratory diseases. Fifty pneumococci recovered from sputum samples (1995 to 2010) from 13 adult patients with ≥3 episodes of acute exacerbation or pneumonia, with the same serotype and pulsed-field gel electrophoresis (PFGE) pattern, were studied. Multilocus sequence typing (MLST) loci, penicillin-binding protein (PBP) genes (pbp2x, pbp1a, pbp2b), and the quinolone-resistant determining regions (QRDRs) of parC, parE, and gyrA were PCR amplified and sequenced. The average time between the first and last episode was 582 days (standard deviation [SD], ±362). All but two patients received multiple courses of β-lactam treatment, and all persistent strains were resistant to penicillin; however, the PBP sequences were stable over time apart from one variable nucleotide in pbp2x, observed among pneumococci isolated from three patients. In contrast, 7/11 patients treated with fluoroquinolones had fluoroquinolone-resistant pneumococci. In three patients, the initially fluoroquinolone-susceptible strain developed resistance after fluoroquinolone therapy, and in the remaining four patients, the persistent strain was fluoroquinolone resistant from the first episode. QRDR changes involved in fluoroquinolone resistance were frequently observed in persistent strains after fluoroquinolone treatment; however, the PBP sequences and MLST genotypes of these strains were stable over time.
机译：肺炎链球菌在引起慢性呼吸道疾病患者急性加重中起重要作用。但是，关于患有慢性呼吸道疾病的成年患者中肺炎球菌持续性的资料很少。研究了从13名成年急性加重或肺炎发作≥3次的成年患者的痰液样本中回收的50例肺炎球菌，这些患者具有相同的血清型和脉冲场凝胶电泳（PFGE）模式。多基因座序列分型（MLST）基因座，青霉素结合蛋白（PBP）基因（ pbp 2 x ， pbp1a ， pbp2b ），对 parC ， parE 和 gyrA 的喹诺酮抗性决定区（QRDR）进行PCR扩增和测序。第一和最后一次发作之间的平均时间为582天（标准差[SD]，±362）。除两名患者外，所有患者均接受了多个疗程的β-内酰胺治疗，所有持久性菌株均对青霉素耐药;然而，在分离自三名患者的肺炎球菌中观察到，PBP序列随时间稳定，除了 pbp 2 x 中的一个可变核苷酸。相反，接受氟喹诺酮类药物治疗的7/11患者患有氟喹诺酮类耐药性肺炎球菌。在三名患者中，最初的氟喹诺酮敏感性菌株在接受氟喹诺酮治疗后出现耐药性，而在其余四名患者中，持久性菌株从一开始就对氟喹诺酮耐药。在氟喹诺酮治疗后的持久性菌株中经常观察到与氟喹诺酮耐药有关的QRDR变化;然而，这些菌株的PBP序列和MLST基因型随时间稳定。

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