耐万古霉素肠球菌的耐药与毒力基因检测  

Drug resistance and virulence determinants in vancomycin-resistant Enterococci

作　　者：杨靖娴[1] 刘静[1] 邵冬华[1] 王树琴[1] 孙娜[1] 吴富炜 梁国威[1] 

机构地区：[1]航天中心医院检验科,北京市100049

出　　处：《实用医学杂志》2014年第1期132-136,共5页The Journal of Practical Medicine

摘　　要：目的:调查万古霉素耐药基因和5种毒力基因在临床分离肠球菌中的分布特点,探讨万古霉素耐药与毒力因子之间的相关性。方法:E-test法检测122株肠球菌对万古霉素和替考拉宁的最低抑菌浓度(MIC),多重PCR法检测vanA、vanB及粪、屎肠球菌的菌种特异基因,同样采用多重PCR法检测常见毒力基因esp、hyl、gelE、asa1以及cylA在上述肠球菌中的分布。结果:共检出76株万古霉素耐药肠球菌(VRE)(屎肠球菌69株,粪肠球菌7株)和46株万古霉素敏感肠球菌(VSE)(屎肠球菌28株,粪肠球菌18株);所有VRE耐药表型与基因型一致,属vanA型;粪肠球菌毒力基因检出率明显高于屎肠球菌,并表现为多基因携带;屎肠球菌仅esp和hyl阳性。屎肠球菌VRE的esp携带率显著高于其VSE。结论:我院肠球菌耐药问题严重,esp基因分布最广泛,且与万古霉素耐药显著相关。加强肠球菌耐药与毒力基因的监测有利于为预防和控制耐药菌的流行与传播提供重要的基础信息。Objective To investigate the prevalence of vancomycin-resistance gene and five virulence determinants in Enterococcus of clinical isolates,and to explore the possible correlations between vancomyein- resistance and virulence determinants. Methods One hundred and twenty-two isolates were collected to detemfine their antimicrobial susceptibility to vancomycin and teicoplanin by E-test. The vanA, vanB and specie specific genes for Entercoccus faecaIis and Entercoccus faecium were detected using multiplex PCR assay. The occurrence of the esp, hyl, gelE, asal and cylA were also detected by multiplex PCR. Results Among the 122 isolates, VRE accounted for 76 including 69 Entercoccus faecium and 7 Entercoccus faecalis, VSE accounted for 46 including 28 Entercoccus faecium and 18 Entercoccus faecafis. All VRE displayed their vancomycin-resistant phenotypes and genotypes, consistently with vanA gene positive. Entercoccus faecalis showed higher prevalence of virulence traits than Entereoecus faecium, which only carried esp and hyl. The presence of esp in vancomycin-resistant Entercoccus faecium was significantly higher than that of the sensitive ones. Conclusion Drug resistance of Enteroeoecus was a serious problem in our hospital. Esp was the most widely distributed gene among five virulence related genes, it had a strong relationship with vancomycin resistance. Monitoring VRE along with their virulence traits will provide valuable information for preventing and control the prevalence and spread of muhidrug-resistant Enterococcus species.

关 键 词：肠球菌属 万古霉素 毒力 

分 类 号：R446.5[医药卫生—诊断学]