高耐庆大霉素肠球菌多重耐药性与aac （6′）-aph（2＂）基因的相关性研究  

The correlation research of aac （6′）-aph（2＂） gene and the multi-resistance in high-level gentamicin- resistant Enterococcus

作　　者：冯霞[1] 王蓉[1] 单斌[1] 马晓波[1] 陈端[1] 

机构地区：[1]昆明医学院第一附属医院检验科,昆明市650032

出　　处：《实用检验医师杂志》2011年第4期210-214,共5页Chinese Journal of Clinical Pathologist

摘　　要：目的 探讨aac（6′）-aph（2＂）基因与高耐庆大霉素肠球菌（high-level gentamicin-resistant Enterococcus,HLGRE）多重耐药的相关性.方法 收集8年间临床分离肠球菌,MIC法检测HLGRE及其多重耐药情况；采用PCR-RFLP法检测随机抽样的100株HLGRE和60株非HLGRE中aac（6′）-aph （2＂）基因的分布情况.结果 共分离1615株肠球菌,其中屎肠球菌879株（54.4％）,粪肠球菌631株（39.1％）,其他肠球菌105株（6.5％）；HLGRE 1132株,其中HLGRE屎肠球菌748株（66.1％）,HLGRE 粪肠球菌384株（33.9％）.各标本中分离的肠球菌以尿液中最多,占62.1％.主要分布于干疗科（15.2％）、移植科（12.0％）、肾内科（10.7％）.HLGRE屎肠球菌对奎奴普汀-达福普汀、万古霉素、替考拉宁的耐药率均为0.0％,对利奈唑胺耐药率仅为2.0％,对其他抗生素耐药率均在77.0％以上；HLGRE粪肠球菌对利奈唑胺、万古霉素、替考拉宁的耐药率均为0.0％,对青霉素、氨苄西林的耐药率低于40.0％,对四环素、庆大霉素、高浓度庆大霉素、奎奴普汀-达福普汀的耐药率均为100.0％.随机抽取的100株HLGRE中aac（6′）-aph（2＂）基因检测的阳性率为97.0％（97株）,aac（6′）-aph（2＂）基因同HLGRE有较好的相关性（r=0.6822,P＜0.05）.PCR产物经克隆测序与GeneBank的序列99％～100％一致.结论 HLGRE较非HLGRE分离率高且多重耐药现象严重.aac（6′）-aph（2＂）基因与HLGRE之间具有较好的相关性.Objective Tostudy the relationship between aac （6′）-aph（2＂） gene and the multi-drug resistance of high-level gentamicin-resistant Enterococcus （HLGRE）. Methods Enterococcus of clinical iso- lated among 8 years were collected. MIC assay was used to detect HLGRE and the multi-drug resistance, PCR- RFLP was used to detect aac （6′）-aph（2＂） gene in 100 strains HLGRE and 60 strains non-HLGRE which were random sampling. Results 1615 strains Enterococcus were isolated including Enterococcus faecium 879 （54.4%）, Enterococc~ faecalis 631 （39.1%）and other Enterococcus 105 （6.5%）. Among 1132 strains HLGRE, there were Enterococcusfaecium 748 （66.1%） and Enterococcusfaecalis 384 （33.9%）. The Enterococcus were mainly distributed in urine（62.1%）, and were isolated main from cadre treat department（15.2%）, transplantation department （12.0%） and urology department （10.7%）. The drug resistance of HLGRE Enterococcus faecium to quinupristin-dalfopristin, vancocin and teicoplanin were all 0.0%, to linezolid was 2.0%, to the other antibiotics were all above 77.0%. The drug resistance of HLGRE Enterococcus faecdis to linezolid, vancocin and te- icoplanin were all 0.0%, to penicillin and ampicillin were lower than 40.0%, to tetracycline, gentamicin, high concentraion gentamicin and quinupristin-dalfopristin were all 100.0%. The positive rate of aac （6′）-aph（2＂） gene in 100 strains HLGRE was 97.0%. There was good correlation between aac （6′）-aph（2＂） gene and HLGRE （r= 0.6822, P〈 0.05）. The gene sequence of PCR products were 99%-100% identical with GeneBank. Conclu- sion The separation rate of HLGRE is higher than non-HLGRE, and multi-drug resistance is more serious. There is good correlation between aac （6′）-aph（2＂） gene and HLGRE.

关 键 词：HLGRE aac(6′)-aph(2") 多重耐药 

分 类 号：R378.1[医药卫生—病原生物学]