消化内科患者感染粪肠球菌毒力基因检测及其耐药性分析  

Detection of virulence genes in and analysis of the drug resistance of Enterococcus faecalis infecting patients in Gastrointestinal Medicine in the Henan area

作　　者：梅懿文 魏林郁[2] 汪群英[1] 

机构地区：[1]郑州大学第一附属医院消化实验室,河南郑州450000 [2]新乡医学院生理教研室,河南新乡453000

出　　处：《中国病原生物学杂志》2015年第4期355-358,367,共5页Journal of Pathogen Biology

摘　　要：目的检测消化内科患者感染的粪肠球菌毒力基因,分析其耐药情况,为粪肠球菌感染患者的临床治疗及药物合理使用提供指导。方法收集河南地区消化内科患者血液、痰液、及尿液标本,分离非重复的粪肠球菌,并使用全自动细菌鉴定仪进行鉴定;制备细菌DNA模板并设计引物、PCR扩增粪肠球菌毒力基因;采用K-B法测定粪肠球菌对常用抗生素的耐药性。结果 PCR扩增河南地区消化内科患者感染的粪肠球菌分离株8种毒力基因cylA、cylB、efaA、cylL1、esp、gelE、cylM和ace,大小分别为327、843、742、624、180、933、1 200、335bp,与理论值相符。粪肠球菌临床分离株8种毒力基因的分布情况各不相同,cylA、cylB、cylM、cylL1、efaA、esp、gelE和ace基因阳性率分别为56.33%、45.77%、48.59%、53.52%、69.72%、57.04%、65.49%、15.49%;药敏试验显示,粪肠球菌临床分离株对替考拉宁未产生耐药性,对红霉素、四环素、庆大霉素、环丙沙星、氨苄西林、呋喃妥因、万古霉素的耐药率分别为81.69%、78.17%、74.65%、53.52%、41.55%、18.31%和7.04%。结论河南地区消化内科患者感染粪球菌8种毒力基因携带率为15.49%～69.72%,细菌对替考拉宁敏感,对红霉素等其他常用抗生素均有不同程度耐药,可供临床治疗时参考。Objectives To detect virulence genes in Enterococcus faecalis infecting patients in Gastrointestinal Medicine in Henan and to analyze the drug resistance of Enterococcus faecalis in order to provide guidance for rational drug use during the clinical treatment of patients infected with E. faecalis. Methods Blood, sputum, and urine samples were collected from patients in Gastrointestinal Medicine in Henan, and 142 unique strains of E. faecalis were isolated. These strains were identified with an automated bacteria identification device. The virulence genes of E. faecalis were amplified by a process including template preparation, primer design, PCR amplification with thermal cycling, and gel electrophore- sis. The drug resistance of E. faecalis was analyzed using the K-B method. Results Eight virulence genes were detec- ted in E. faecalis isolates infecting patients in Gastrointestinal Medicine in Henan. Amplification indicated that the cylA gene was 327 bp in size, the cylB gene was 843 bp in size, the efaA gene was 742 bp in size, the cylL1 gene was 624 bp in size, the esp gene was 180 bp in size, the gelE gene was 933 bp in size, the cylM gene was 1,200 bp in size, and the ace gene was 335 bp in size. Eight virulence genes were amplified with PCR, and their distribution in clinical isolates of E. faecalis differed. The cylA gene was detected in 56.33% of the142 clinical isolates of E. faecalis, the cylB gene was detected in 45.77%, the cylM gene was detected in 48.59%, the cylL1 gene was detected in 53.52~, the efaA gene was detected in 69.72~, the esp gene was detected in 57.04%, the gelE gene was detected in 65.49%, and the ace gene was detected in 57.04%. The drug resistance of the clinical isolates of E. faecalis was analyzed using the K-B method. The highest rate of resistance was to erythromycin and the lowest rate of resistance was to vancomycin. E. faecalis was not resistant to teicoplanin. E. faecalis resistance to erythromycin was 81.69 %, its resistance to tetracycline was 78.17 %, its resistanc

关 键 词：消化内科 粪肠球菌 毒力基因 K-B法 耐药性 

分 类 号：R378.1[医药卫生—病原生物学]