儿童肠球菌多重耐药与Ⅰ类整合子的检测  

Multidrug resistance of Enterococcal isolates in pediatric and test of class Ⅰ integron

作　　者：吕萍[1] 徐樨巍[1] 宋文琪[1] 董方[1] 杨永弘[1] 沈叙庄[1] 

机构地区：[1]首都医科大学附属北京儿童医院,北京100045

出　　处：《检验医学》2009年第3期219-222,共4页Laboratory Medicine

基　　金：国家科技部十五攻关课题基金资助项目(2004BA720A09-01)

摘　　要：目的了解儿童临床分离肠球菌的耐药特征及其多重耐药与Ⅰ类整合子的相互关系。方法采用琼脂稀释法测定常用抗菌药物对152株肠球菌的最低抑菌浓度(MIC),用聚合酶链反应(PCR)检测肠球菌Ⅰ类整合子和Ⅰ类整合酶基因。结果屎肠球菌对氨苄西林、阿莫西林-克拉维酸、环丙沙星的耐药率分别为96.8%、95.2%和84.1%,粪肠球菌对上述3种抗菌药物的耐药率分别为23.6%、18.0%和49.4%,屎肠球菌的耐药率明显高于粪肠球菌(P<0.001);粪肠球菌中有2株对万古霉素的MIC为8μg/mL,粪肠球菌和屎肠球菌对替考拉宁均敏感。儿童多重耐药肠球菌发生率高达93.7%。屎肠球菌耐药模式以耐氨苄西林、红霉素、环丙沙星、利福平、四环素、高水平庆大霉素6种抗菌药物为主,占屎肠球菌的59%,粪肠球菌以耐四环素、红霉素、利福平、氯霉素、高水平庆大霉素5种抗菌药物为主,占粪肠球菌的26%。全部152株肠球菌未检测到Ⅰ类整合子,仅有5株检测到Ⅰ类整合酶基因。结论儿童肠球菌多重耐药十分严重,儿童肠球菌多重耐药与Ⅰ类整合子和Ⅰ类整合酶基因尚无明显关系。Objective To explore the resistant characteristic and the correlation between muhidrug resistance and class Ⅰ integron in Enterococcal isolates from children. Methods Mininal inhibitory concentrations （MIC） of 152 En- terocoecal isolates were determined by agar dilution. Class Ⅰ integron and class Ⅰintegrase were detected by polymerase chain reaction （PCR）. Results The resistant rate of Enterococci faecium （ E. faecium） to ampicillin, amoxicillin-clavu- lanie aeid,ciprofloxaein was 96.8% ,95.2% and 84.1% respectively. The resistant rate of E. faecalis to ampicillin, amoxicillin-clavulanic acid, ciprofloxacin was 23.6% , 18.0% and 49.4% respectively. The resistant rates of E. faecium to ampicillin, amoxicillin-clavulanic acid, ciprofloxacin were higher than E. faecalis （ P 〈 0.001 ）. The MIC of vancomycin was 8 μg/mL in two E. faeealis. E. faeealis and E. faeeium isolates were all susceptible to teicoplanin. The muhiresistant rate to antibiotic in the Enteroeocci was 93.7%. The patterns of multiresistance to antibiotic in E.faecium were ampicil- lin, erythromycin, tetracycline, ciprofloxcin, rifampin, high level gentamicin. The patterns of muhiresistance to antibiotic in E. faecalis were tetracycline, erythromycin, rifampin, chloramphenicol, high level gentamicin. Class I integron was nega- tive among all the Enterococcal isolates, only five Enterococcal isolates were tested class I integrase. Conclusions The antimicrobial resistant status of the Enterococci is very serious. The muhidrug resistance has no correlation to class Ⅰ inte- gron and class Ⅰ integrase.

关 键 词：肠球菌 整合酶基因 整合子 多重耐药 

分 类 号：R378.1[医药卫生—病原生物学]