摘要
背景：这项工作报告了2007-2020年由“侵袭性A组链球菌监测计划”收集的西班牙侵袭性化脓性链球菌的抗微生物耐药性数据。方法：通过测序确定emm分型。通过E试验测定对青霉素、四环素、红霉素和克林霉素的敏感性。通过PCR寻找tetM、tetO、msrD、mefA、ermB、ermTR和ermT。使用红霉素-克林霉素双圆盘试验检测大环内酯类耐药表型（M、cMLSB和iMLSB）。抗性克隆通过其emm型、多位点序列型（ST）、抗性基因型和大环内酯类抗性表型进行鉴定。结果：青霉素的敏感性是普遍的。237/1983个分离株（12.0%）记录到四环素耐药性（152个仅携带tetM，48个仅携带tetO，33个同时携带两者）。在172/1983个分离株中检测到红霉素耐药性（8.7%）；ermB存在于83例，mefA存在于58例，msrD存在于51例，ermTR存在于46例，ermT存在于36例。78/1983个分离株中存在克林霉素耐药性（甲基化酶介导）（3.9%）。鉴定出8个主要耐药克隆：2个仅对四环素耐药（emm22/ST46/tetM和emm77/ST63/tetO），3个仅对红霉素耐药（emm4/ST39/mefA-msrD/M、emm12/ST36/mefA-ms rD/M和emm28/ST52/ermB/cMLSB），以及三种四环素-红霉素共耐药（emm11/ST403/ttetM-ermB/cMLSB、emm77/ST63/tetO-ermTR/iMLSB和emm77/ST63/tetM-emtO-ermTR/iMLSB）。结论：2007年至2020年间，四环素、红霉素和克林霉素的耐药率有所下降。抗性克隆比例的时间变化决定了抗性率的变化。
Abstract
Background: This work reports on antimicrobial resistance data for invasive Streptococcus pyogenes in Spain, collected by the ‘Surveillance Program for Invasive Group A Streptococcus’, in 2007–2020. Methods: emm typing was determined by sequencing. Susceptibility to penicillin, tetracycline, erythromycin, and clindamycin was determined via the E-test. tetM, tetO, msrD, mefA, ermB, ermTR, and ermT were sought by PCR. Macrolide-resistant phenotypes (M, cMLSB, and iMLSB) were detected using the erythromycin–clindamycin double-disk test. Resistant clones were identified via their emm type, multilocus sequence type (ST), resistance genotype, and macrolide resistance phenotype. Results: Penicillin susceptibility was universal. Tetracycline resistance was recorded for 237/1983 isolates (12.0%) (152 carried only tetM, 48 carried only tetO, and 33 carried both). Erythromycin resistance was detected in 172/1983 isolates (8.7%); ermB was present in 83, mefA in 58, msrD in 51, ermTR in 46, and ermT in 36. Clindamycin resistance (methylase-mediated) was present in 78/1983 isolates (3.9%). Eight main resistant clones were identified: two that were tetracycline-resistant only (emm22/ST46/tetM and emm77/ST63/tetO), three that were erythromycin-resistant only (emm4/ST39/mefA-msrD/M, emm12/ST36/mefA-msrD/M, and emm28/ST52/ermB/cMLSB), and three that were tetracycline–erythromycin co-resistant (emm11/ST403/tetM-ermB/cMLSB, emm77/ST63/tetO-ermTR/iMLSB, and emm77/ST63/tetM-tetO-ermTR/iMLSB). Conclusions: Tetracycline, erythromycin, and clindamycin resistance rates declined between 2007 and 2020. Temporal variations in the proportion of resistant clones determined the change in resistance rates.

https://www.mdpi.com/2079-6382/12/1/99