临床与环境分离肠球菌属的耐药性及同源性分析  

Drug resistance and homology of Enterococciisolated from hospital and environment

作　　者：陆庭嫣[1] 杨晓青[1] 沈俐[1] 吕焱[1] 唐振华[1] 

机构地区：[1]上海交通大学医学院附属国际和平妇幼保健院检验科,上海200030

出　　处：《中华医院感染学杂志》2013年第6期1224-1227,共4页Chinese Journal of Nosocomiology

摘　　要：目的利用分子分型方法,调查住院患者各类标本中分离到的肠球菌属与环境中肠球菌属分离株之间的同源性,探寻肠球菌属医院感染的传播途径及潜在高危环节。方法收集于同时期医院医疗环境及临床标本的51株粪肠球菌和16株屎肠球菌作为研究对象,用VITEK-32微生物鉴定药敏分析系统进行菌种鉴定和药敏;利用Diversilab基因分型系统进行同源性分析。结果肠球菌属分离未发现万古霉素耐药株,同时为耐高水平氨基糖苷类粪肠球菌9.8%、屎肠球菌12.5%;Diversilab基因分型系统将51株粪肠球菌分成5组流行克隆和17株散发克隆,16株屎肠球菌分成3组流行克隆和4株散发克隆。结论粪肠球菌对一般所选抗菌药物敏感性高,屎肠球菌对抗菌药物的耐药率明显高于粪肠球菌;肠球菌属的医院感染形式有交叉感染、自身感染、母婴垂直感染,其中以粪肠球菌G1组克隆的产科交叉感染为主要存在感染形式,此外环境中感染菌定植也是医院感染播散的重要环节。OBJECTIVE To investigate the DNA homology of Enterococci isolated from hospitalized patients and the environment based on molecular genotyping and explore the transmission route of Enterococci infections and the links with potential hidden dangers METHODS Fifty-one strains of Enterococcus faecalis and sixteen strains of Enterococcus faecium isolates from hospitalized patients a.nd the environment were identified and the drug susceptibility testing was performed by VITEK-32 system. Diversilab genotyping system was employed to analyze the homology. RESULTS No vancomycin-resistant strains have been found in the Enterococci isolates. There were high-level aminoglycoside-resistant E. faecalis （9.8%） and E. faecium （12.5 %） . Fifty-one E. faecalis isolates were divided into 5 clusters and 17 unique types, and sixteen E. faecium isolates were divided into 3 clusters and 4 unique types by Diversilab genotyping system. CONCLUSION E . faecalis is highly sensitive to the selected antibiotics, the drug resistance rate of E. faecium is significantly higher than that of E. faecalis. Enterococci can cause various types of nosocomial infections including the cross-infections, self-infections, and maternal and child vertical infections, among which the cross-infections caused by E. faecalis Gl clusters in obstetrics are dominant. The colonization of bacteria causing infections in the environment is an important link for the transmission of nosocomial infections.

关 键 词：肠球菌属 Diversilab基因分型系统 同源性 耐药率 

分 类 号：R378.1[医药卫生—病原生物学]