健康成人与住院病人肠球菌致病基因及表型和耐药性的比较研究  

Study on virulence determinants, phenotypes and drug resistance of enterococcus from inpatients and healthy adults

作　　者：马立艳[1] 许淑珍[1] 

机构地区：[1]首都医科大学附属北京友谊医院,北京100050

出　　处：《临床和实验医学杂志》2006年第1期5-7,共3页Journal of Clinical and Experimental Medicine

基　　金：北京市自然科学基金项目资助(7012013)

摘　　要：目的 调查健康成人与住院病人分离肠球菌致病基因、致病表型和耐药性的携带情况,以了解肠球菌在医院感染中的意义.方法 应用PCR检测肠球菌cylA、gelE、esp、ace、agg和efaA等6种致病基因,并用斑点杂交和基因测序确证.应用β溶血试验、明胶溶解和生物膜形成检测3种致病表型.应用琼脂稀释法检测肠球菌对高浓度庆大霉素、高浓度链霉素、万古霉素和氨苄西林的耐药性.结果 健康成人和住院病人粪肠球菌中均检测到6种致病基因,前者检出率7.4～40.7%,后者检出率29.0～80.6%;屎肠球菌健康成人分离菌株检测出3种致病基因,检出率5.6～16.7%;住院病人分离菌株检测出4种致病基因,检出率21.1～57.9%.健康成人和住院病人肠球菌β溶血、明胶溶解和生物膜形成的检出率分别为26.7%,54.0%;13.3%,40.0%;97.8%,90.0%.健康成人和住院病人屎肠球菌耐药率分别为22.2～94.4%,68.4～100.0%;粪肠球菌分别为3.7～33.3%,29.0～64.5%.结论 健康成人分离株较住院病人分离株的致病性弱,屎肠球菌比粪肠球菌的耐药性高.Objective To eornpare the incidence of six virulence detenninants, three phenotypes and drug resistance in enterecocci isolated from inpatients and healthy adults. To find out the significance of enteroeoceus in nosocomial infection, Methods PCR was used to detect the six virulence determinants, ineluding cylA, gelE, esp, ace, agg and efaA, Sequencing and dot blot were taken as confimation tests, And the thrce phenotypes, including β - hemolysis , gelatin hydrolysis and biofilm fomation were determined on agar plate containing 7% rabbit blood , Todd - Hewwitt agar plate supplemented with 3% gelatin and 96 well polystyrene plates, respeetively. Antibiotic susceptibility test was performed by agar dilution method. Results Thd detection rates of the six virulence determinants of Enteracoecus faeealis were： 7.4- 40.7% in healthy adults, 29.0-80.6% in inpatients. In E. faccium strains, the number of detected genes and the detection rates were： 3 and 5.6 - 16.7% in healthy adults, 4 and 21.1 - 57.9% in inpatients, respectively, The β- hemolysis , gelatin hydrolysis and biofilm formation of isolated strains from healthy adults and inpatients were 26.7% ,54,0%;13.3% ,40.0% ;97,8% ,90.0%, respectively. E. faeeium have a higher resistant percentage to Amp, high level Gm and Sm than do E. faecalis, Conclusions Strains isolated from healthy adults are much less pathogenitic than that from inpatients. Drug resistance of E. faecium was much more serious than that of E, faecalis.

关 键 词：肠球菌属 致病性 耐药 基因 

分 类 号：R446.5[医药卫生—诊断学]