Comparative Analysis of Levofloxacin Resistant Genes in Clinically Isolated Streptococcus pneumoniae

임상에서 분리한 Streptococcus pneumoniae에서 Levofloxacin 내성유전자의 비교 연구

One hundred seventy four Streptococcus pneumoniae clinical isolates were categorized depending on the types of specimens, the age and the gender, respectively. All isolates were analyzed the characteristics of the multi-drug resistance including levofloxacin antibiotics. In the results of analysis depending on the type of samples, it had been confirmed that sputum was the main source of pneumonia infection because 156 of 174 strains (89.7%) were isolated in sputum samples. The opportunity for isolating the S. pneumoniae that had tolerance to levofloxacin was increased in over 51 age patients group compared with other age and male group. Eight strains of isolates were evaluated higher resistant to levofloxacin, and those also showed multi-drug resistant including penicillin, tetracycline, erythromycin, clindamycin and trimethoprim-sulfamethoxazole. In the results of sequence analysis of quinolone resistance determining region in SP32 (MIC $64{\mu}g/mL$) and SP96 (MIC $8{\mu}g/mL$) which were levofloxacin resistant strains, an amino acid substitutions were found Ser-81$\rightarrow$Phe in both GyrA of SP32 and SP96, and Ser-11$\rightarrow$Gly in only SP96. A Ser-79$\rightarrow$Phe substitution of ParC was found in both.

임상에서 분리한 총 174 균주의 S. pneumoniae를 대상으로 검체별, 연령별, 성별 분리빈도 및 levofloxacin의 내성도를 조사하였으며, 항생제 감수성 검사를 통해 다제내성도를 확인하였다. S. pneumoniae가 가장 많이 분리된 검체는 객담으로서 총 174 균주의 89.7%인 156 균주가 분리되었다. 특히 남성과 51세의 고령환자에서 분리빈도가 높았으며, 분리된 levofloxacin 내성 8 균주 모두는 penicillin, tetracycle, erytromycin, clindamycin 및 trimethoprim-sulfamethoxazoe 대한 다제내성도 함께 소유하고 있는 것으로 확인되었다. 분리된 levofloxacin 내성균주 SP32 (MIC $64{\mu}g/mL$)와 SP96 (MIC $8{\mu}g/mL$)의 QRDR 염기서열을 분석한 결과, SP32와 SP96 균주의 GyrA에서 Ser-81$\rightarrow$Phe로, SP96에서 Ser-11$\rightarrow$Gly으로 아미노산 치환이 각각 확인되었고, ParC에서는 두 균주 모두 Ser-79$\rightarrow$Phe으로 치환된 돌연변이가 확인되었다.