利奈唑胺耐药粪肠球菌感染患者临床分离株与定植株同源性分析  

Homology analysis of clinically isolated and colonized linezolid-resistant Enterococcus faecalis strains from a patient

作　　者：蒲彰雅 余治健[1] 陈重[1] 邓向斌[1] 白冰[1] 李多云[1] 刘晓军[1] 韩雪莹[1] 林佛君 邓启文[1] 

机构地区：[1]广东医科大学附属深圳市南山区人民医院深圳市内源性感染诊治研究重点实验室,广东深圳518052

出　　处：《中国感染控制杂志》2017年第4期343-345,350,共4页Chinese Journal of Infection Control

基　　金：深圳市科技创新委基础研究基金项目(JCYJ20150402152130173);深圳市南山区科技项目(2015019;2015022)

摘　　要：目的研究1例患者体内利奈唑胺(LZD)耐药粪肠球菌临床分离株与定植株同源性特点。方法对1例肺部感染患者分离的10株粪肠球菌(其中2株分离自尿标本,8株分离自粪便标本)进行细菌耐药分析,并通过脉冲场凝胶电泳(PFGE)确定粪肠球菌之间的同源性。结果患者进行LZD治疗前后,尿标本分离出的2株粪肠球菌均为LZD耐药株(MIC值分别为8 mg/mL,16 mg/mL),粪便中培养挑取的8株(治疗前6株,治疗后2株),其中LZD敏感4株,中介2株,耐药2株(MIC值波动在0.25~12 mg/mL)。通过PFGE分型检测提示10株粪肠球菌具有同源性。结论该例患者泌尿道和肠道检出的粪肠球菌具有同源性,提示LZD耐药肠球菌可能长期定植于患者体内,并可能发生移位导致耐药细菌感染。Objective To study the homology characteristics of clinicaly isolated and colonized linezolid（LZD）-resistant Enterococcus faecalis （E.faecalis） strains from a patient.Methods Ten E.faecalis strains （2 were isolated from urine specimens and 8 were from stool specimens） isolated from a patient with pulmonary infection were performed antimicrobial susceptibility testing, homology of E.faecalis was determined by pulsed-field gel electrophoresis （PFGE）.Results Before and after patients received LZD therapy, 2 E.faecalis strains isolated form urine specimens were both resistant to LZD （MICs： 8 mg/mL, 16 mg/mL, respectively）, among 8 strains from stool specimens （6 were isolated before therapy, and 2 were isolated after therapy）, LZD susceptible, intermediate, and resistant strains were 4, 2, and 2 respectively（MICs： 0.25-12 mg/mL）.10 strains of E.faecalis were homologous by PFGE typing.Conclusion In this case, the detection of E.faecalis from urinary tract and intestinal tract is homologous, which suggested that LZD-resistant Enterococcus may be colonized in vivo for a long time, and may be shift to cause bacterial infection.

关 键 词：利奈唑胺 粪肠球菌 临床耐药 定植 同源性 

分 类 号：R378.1[医药卫生—病原生物学]