屎肠球菌和粪肠球菌多位点序列分型及耐药相关性研究  

Multilocus sequence typing of Enterococcus faecium and Enterococcus faecalis and the relationship between sequence types and drug resistance

作　　者：邹绍伟 王占黎[2] 王英[1] 牛海英[3] 张利霞[4] 

机构地区：[1]包头医学院流行病学教研室,内蒙古包头014060 [2]包头医学院第二附属医院检验科 [3]包头医学院第一附属医院呼吸科 [4]包头医学院第一附属医院检验科

出　　处：《中国病原生物学杂志》2018年第1期22-26,33,共6页Journal of Pathogen Biology

基　　金：国家自然科学基金项目(No.81360242;81460049)

摘　　要：目的研究屎肠球菌和粪肠球菌的多位点序列分型(multilocus sequence typing,MLST)及其应耐药性,为防控院内感染提供基础数据。方法收集2013年1月-2016年12月包头地区同一医院来源的粪肠球菌58株和屎肠球菌74株,随机抽取粪肠球菌菌株29株和屎肠球菌菌株37株为实验菌株,采用聚合酶链反应(PCR)法及基因测序技术分别检测粪肠球菌看家基因(gdh、gyd、stS、gki、xpt、aroE、yqiL)和屎肠球菌看家基因(adk,atpA,ddl,gdh,gyd,purK,pstS);将测序结果与相应菌群数据库比较,获得屎肠球菌、粪肠球菌菌株的序列型(STs)。采用VITEK-2Compact全自动微生物鉴定仪及药敏系统鉴定肠球菌并同步测定9种抗菌药物(氨苄西林、青霉素、四环素、红霉素、左氧氟沙星、环丙沙星、万古霉素、庆大霉素、链霉素)MIC值。结果粪肠球菌分离株总分为10个ST型,其中13株等位基因谱相同,为ST179,占44.83%;屎肠球菌分离株分为10个ST型,其中14株等位基因谱相同,为ST78,占40.00%。屎肠球菌对红霉素耐药率最高,为100%;粪肠球菌对四环素耐药率最高,为72.4%。两类肠球菌均未检出万古霉素耐药分离株。粪肠球菌庆大霉素耐药和链霉素敏感株中ST179均占45.83%,屎肠球菌庆大霉素耐药和链霉素耐药菌中ST78均占34.23%。结论屎肠球菌、粪肠球菌的优势菌型分别为ST78和ST179。针对性使用肠球菌优势菌型敏感药物,严格抗生素管理,是提高粪肠球菌感染治愈率,有效控制院内感染的优先措施。Objectives To multilocus sequence type （MLST） Enterococcus faecium and Enterococcus faecalis and to study their drug resistance in order to provide basic data for prevention and control of nosocomial infections. Methods A total of 58 strains of E. faecalis and 74 strains of E. faecium were collected in Baotou from January 2013 to December 2016. Of the 135 enterococeal isolates evaluated, 29 strains of E. faecalis and 37 strains of E. faecium were selected for further detection of E. faecalis housekeeping genes （gdh, gyd, stS, gki, xpt, aroE, and yqiL） and E. Jaecfum house- keeping genes （adk, atpA, ddl, gdh, gyd, purK, and pstS） using PCR and gene sequencing. Sequencing results were compared to corresponding sequences of E. faeciura and E. faecalis strains obtained from databases. The isolates were i- dentified as enterococci using conventional biochemical tests and VITEK 2 Compact. The antimicrobial susceptibility of the isolates was determined using the disk diffusion technique with the Kirby-Bauer （K-B） method. Results The E＇. faecalis isolates were typed as 10 sequence types （STs）, and those STs had la o~ the same alleles （44.83%） as ST179. E. faeciu＊n isolates were types as 10 STs, and those STs had 14 of the same alleles （40G） as ST78. E. faecium was most resistant to erythromycin （100 ~）, and E. faecalis was most resistant to tetracycline （72.4 ~）. Neither of the spe- cies of Enterococcus were resistant to vancomyein. Forty-five-point-eight-three percent of gentamicin-resistant and strep- tomycin-sensitive strains of E. faecalis were typed as ST179, and 34.23% of streptomycin resistant and streptomycin-re- sistant strains of E. faecium were typed as ST78. Conclusion The predominant type of E. faecium was ST78 and the predominant type of E. faecczlis was ST179. Targeted use of drugs to which the predominant type of Enterococcus is sensitive and strict drug management are priority measures to better treat enterococcal infections and effectively control noso comial infe

关 键 词：粪肠球菌 屎肠球菌 多位点序列分型 耐药性 

分 类 号：R378.1[医药卫生—病原生物学]