What _'s general knowledge is pneumonia streptococcus able to bear the erythromycin reason

What _'s general knowledge is pneumonia streptococcus able to bear the erythromycin reason
The intersection of pneumonia and to to it able to bear medicines to be one in whole world issue that scholar pay close attention to the fact antibiotic streptococcus. The pneumonia streptococcus is the most common pathogen of acquired character pneumonia of community, since in 1967 Australia reported the first was able to bear the pneumonia streptococcus of medicine to penicillin, the intersection of pneumonia and to to able to bear the intersection of medicine and rate in increase, concern by scholar so as to penicillin and erythromycin most particularly among them year by year antibiotic streptococcus. Statistics of our country reveal the intersection of pneumonia and streptococcus that separate 1997- 2000 year rate here to to able to bear medicine penicillin 8.8% - 22.5% , Rate to to able to bear medicine erythromycin 42.5% - 76.8% . Domestic scholar Zhao TieMei,etc. studied 192 measured and separated the pneumonia streptococcus clinically in 2003, one that is to penicillin able to bear medicine rate 42.7%, one that is to erythromycin able to bear medicine rate 77.6%.
The research in recent years shows, the mechanism that the pneumonia streptococcus is able to bear medicine to big intra-annular ester antibiotic involves a plurality of respects.
The location of target changes
Able to bear the intersection of medicine and genetic erm, encode, it able to bear the intersection of medicine and phenotype for able to bear medicine (mlsb) alternately to large intra-annular ester, forest but amide and the intersection of chain and open the intersection of fungus and plain b . Based on different expression ways, are divided into cmls and imls and able to bear medicines again. Erm genetic overwhelming majority in the pneumonia streptococcus is ermb gene, a few is lain between and lead by ermtr gene.
Exclusive system voluntarily
Lie between, lead by the intersection of mefa and gene, able to bear the intersection of medicine and phenotype until to the intersection of 14 - 15 and the intersection of ring and old intra-annular ester low-level to able to bear medicines antibiotic, and mould and plain to 16 ring big intra-annular esters antibiotic, Klim and the open fungus plain b of chain is sensitive, namely m type.
23srrna and (or) Ribosomes albumen l4 sudden change
In Italy, Belgium, Spain, South Africa, pneumonia streptococcus able to bear nature, change to big intra-annular ester antibiotic for the intersection of target and location mainly. Rely mainly on able to bear medicines in m typing in countries such as U.S.A., Canada,etc.. Zhao TieMei's research reveals, 148 of erythromycin are able to bear the medicine one, is able to bear the medicine gene with ermb gene (79.1%) Lie between and lead it as the main fact; Able to bear the medicine phenotype and able to bear medicines with the mls type ' 89.2% ) It is a main fact, among them cmls accounts for 85.1%, imls accounts for 4.1%, has not measured the gene to ermtr.
Foreign scholar granizo,etc. thinks, the wide application of big intra-annular ester antibiotic may be the main reason that erythromycin is able to bear medicines to increase, he review big intra-annular ester use and the intersection of pneumonia and streptococcus of antibiotic able to bear the medicine situation to reveal in the past 19 years: The consumption which is able to bear medicine and big intra-annular ester medicine of erythromycin has very high relevance, different application which is able to bear medicine mechanism and big different kinds of intra-annular ester antibiotic of erythromycin has not been concerned with. In Japan, big intra-annular ester antibiotic of 16 rings is employed extensively, but 40% erythromycin is able to bear the medicine pneumonia streptococcus and carry mefa gene. In some areas of Europe, big intra-annular ester antibiotic of 16 rings is employed little of, but it is actually rare that the one that arrange leading to the fact outside voluntarily is able to bear medicines. In Belgium, are able to bear the medicine pneumonia streptococcus and arrange the mechanism and result in only accounting for 8.5% able to bear medicinesing outside voluntarily. Whether its different regional disparity which is able to bear the medicine mechanism relates to the fact that many medicines are able to bear the cloning and spreading of medicine one, need to further study. And the scholar reports, the pneumonia streptococcus which carries ermb gene is greater than 32 micrograms ml more to mic value of erythromycin, and mic value of carrying the pneumonia streptococcus of mefa gene is less than 32 micrograms ml more. According to different to able to bear the intersection of medicine and gene and erythromycin, able to bear the intersection of medicine and relation of high or low prices, the scholar proposes, carat mould and plain taking the place of dynamics, organize and it infects density of position to be relatively high by the intersection of A and very mould the intersection of disposition and special medicine their, so the one that treat and carry mefa gene is able to bear the erythromycin pneumonia streptococcus should be effective, but there is no animal's experiment or clinical trial to verify yet at present, still need to further study.
|