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首页> 外文期刊>Journal of chemotherapy >Prevalence and characterization of macrolide resistance in clinical isolates of Streptococcus pneumoniae and Streptococcus pyogenes from North America.
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Prevalence and characterization of macrolide resistance in clinical isolates of Streptococcus pneumoniae and Streptococcus pyogenes from North America.

机译：北美肺炎链球菌和化脓性链球菌临床分离株中大环内酯类药物耐药性的流行和特征。

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摘要

Resistance to macrolides is not a new phenomenon but it deserves attention because of the widespread use of these agents and their inclusion in many clinical guidelines for respiratory tract infections. The most common mechanisms by which Streptococcus pneumoniae and Streptococcus pyogenes develop resistance to macrolides is by target site modification (erythromycin ribosome methylase, erm) and efflux of the drug out of the organisms (macrolide efflux, mef). Target site modification may be of greater concern because it confers high-level resistance to all antimicrobials in the macrolide-lincosamide-streptograminB (MLSB) group. The genotype profiles of macrolide-resistant S. pneumoniae and S. pyogenes differ somewhat across regions in the US and between the US and Canada and other countries. There is some evidence for an association between macrolide resistance and treatment failure but this must be researched more fully. S. pneumoniae and S. pyogenes isolates resistant to macrolides are generally susceptible to ketolide antimicrobials because these agents bind more strongly to the relevant domain of the ribosomal subunit (withstanding erm resistance) and are less vulnerable to efflux compared to the macrolides.
机译：对大环内酯类药物的耐药性不是一个新现象，但由于这些药物的广泛使用及其在呼吸道感染的许多临床指南中的应用，因此值得关注。肺炎链球菌和化脓性链球菌对大环内酯类产生耐药性的最常见机制是通过靶位点修饰（红霉素核糖体甲基化酶，erm）和药物从生物体中流出（大环内酯流出，mef）。靶位点修饰可能会引起更大的关注，因为它赋予大环内酯-林可酰胺-链霉菌素B（MLSB）组中的所有抗菌药物以高水平耐药性。耐大环内酯的肺炎链球菌和化脓性链球菌的基因型概况在美国不同地区以及美国和加拿大及其他国家之间有所不同。有一些证据表明大环内酯类药物的耐药性与治疗失败之间存在关联，但是必须对此进行更充分的研究。对大环内酯类有抗药性的肺炎链球菌和化脓性链球菌通常对酮内酯类抗生素敏感，因为与大环内酯类相比，这些药物与核糖体亚基的相关区域结合更牢固（具有抗性），并且不易流出。

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