DETEKCIJA REZISTENCIJE NA ANTIBIOTIKE I KAPSULARNIH TIPOVA STREPTOKOKA GRUPE B IZOLOVANIH KOD KOLONIZOVANIH TRUDNICA

  • Bojana Paunović Institut za mikrobiologiju i imunologiju, Medicinski fakultet, Univerzitet u Beogradu
  • Dušan Kekić Institut za mikrobiologiju i imunologiju, Medicinski fakultet, Univerzitet u Beogradu
  • Jovana Kabić Institut za mikrobiologiju i imunologiju, Medicinski fakultet, Univerzitet u Beogradu
  • Ina Gajić Institut za mikrobiologiju i imunologiju, Medicinski fakultet, Univerzitet u Beogradu
  • Miloš Jovićević Institut za mikrobiologiju i imunologiju, Medicinski fakultet, Univerzitet u Beogradu
DOI: https://doi.org/10.5937/mp74-39252
Ključne reči: Grupa B streptokoka, Rezistencija, kapsularna distribucija, Klon ST17

Sažetak


Uvod: Streptokok grupe B (GBS) predstavlja oportunističkog patogena koji kolonizuje gastrointestinalni i genitalni trakt 10-30% zdravih ljudi. GBS može prouzrokovati ranu ili kasnu neonatalnu bolest koje se najčešće manifestuju kao pneumonija, sepsa i meningitis. Penicilini predstavljaju prvi izbor u lečenju i prevenciji transmisije GBS, a kod alergije na penicilin koriste se makrolidi ili vankomicin. Cilj našeg istraživanja je bio da se za sojeve GBS izolovane iz vaginalnih briseva trudnica ispita osetljivost na antibiotike i fenotip rezistencije na makrolide, kao i određivanje kapsularnih tipova i detekcija hipervirulentnog klona ST17.

Materijal i metode: U periodu od 1. januara do 31. decembra 2021. godine je iz vaginalnih briseva trudnica izolovano 134 soja GBS. Identifikacija je vršena konvencionalnim mikrobiološkim tehnikama i molekularnom detekcijom species-specifičnog dltR gena. Za ispitivanje osetljivosti na antibiotike korišćen je disk-difuzioni metod prema EUCAST standardu. Kapsularna tipizacija GBS rađena je multiplex PCR metodom, a detekcija hvgA, odnosno hipervirulentnog klona ST17gena, PCR metodom.

Rezultati: Svi izolati bili su osetljivi na penicilin, vankomicin i fluorohinolone. Rezistencija na tetraciklin je bila najučestalija i uočena je kod 81,3% (109/134) izolata. Rezistencija na makrolide je detektovana kod 37,3% (50/134), dok je 14,9% izolata GBS pokazivalo rezistenciju na visoke doze gentamicina. Kod dva izolata (1,5%) uočena je rezistencija na hloramfenikol. Najučestaliji fenotip rezistencije na makrolide je cMLS (31/50, 62,0%). Najčešće identifikovani polisaharidni kapsularni tipovi su bili tip V, koji je nađen kod 33 izolata (25,0%) i tip III koji je identifikovan kod 30 sojeva (22,0%). Hipervirulentni klon ST17 je detektovan kod 12,7% (17/134) izolata, od čega je 15 pripadalo tipu III, a dva tipu IV kapsularnom tipu.

Zaključak: Visoka učestalost rezistencije na makrolide kod sojeva grupe B streptokoka izolovanih iz uzoraka kolonizovanih trudnica je zabrinjavajuća. Detekcija velikog broja izolata kapsularnog tipa III i hiperviruletnog klona ST17, ukazuje na potrebu sprovođenja kontinuiranog skrininga i  praćenje prevalencije GBS infekcija trudnica i neonatusa.

Biografije autora

Dušan Kekić, Institut za mikrobiologiju i imunologiju, Medicinski fakultet, Univerzitet u Beogradu

asistent

Jovana Kabić, Institut za mikrobiologiju i imunologiju, Medicinski fakultet, Univerzitet u Beogradu

Istraživač saradnik

Ina Gajić, Institut za mikrobiologiju i imunologiju, Medicinski fakultet, Univerzitet u Beogradu

Docent

Miloš Jovićević, Institut za mikrobiologiju i imunologiju, Medicinski fakultet, Univerzitet u Beogradu

Saradnik u nastavi

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Objavljeno
2024/02/22
Broj časopisa
Vol. 74 Br. 5 (2023): Medicinski podmladak
Rubrika
Originalni naučni članak