万古霉素耐药肠球菌分子流行病学及耐药性分析  

Analysis of drug resistance and molecular epidemiology of vancomycin-resistant Enterococcus

作　　者：周珊 刘家云 徐修礼 杨玉琪 周柯 周磊 郝晓柯 ZHOU Shan;LIU Jia-yun;XU Xiu-li;YANG Yu-qi;ZHOU Ke;ZHOU Lei;HAO Xiao-ke(Clinical Laboratory,Xijing Hospital,Air Force Medical University,Xi’an 710032,Shaanxi Province,China)

机构地区：[1]空军军医大学附属西京医院检验科,陕西西安710032

出　　处：《中国临床药理学杂志》2020年第19期3099-3102,共4页The Chinese Journal of Clinical Pharmacology

基　　金：陕西省自然基金青年基金资助项目(2020JQ-459)。

摘　　要：目的分析本院近10年万古霉素耐药肠球菌(VRE)耐药及分子流行病学情况。方法收集2010—2019年临床分离的VRE,用VITEK2-compact全自动细菌鉴定仪对细菌进行鉴定及药物敏感性试验。用多重聚合酶链反应进行van基因分型,用多位点序列分型(MLST)进行分子分型。结果10年间共分离肠球菌4564株,其中VRE 29株。VRE对多种抗生素耐药,其耐药基因均为vanA型。29株VRE分属7个MLST型别,其中ST78型19株,ST17型5株,剩余5株分别是ST18、ST389、ST80、ST564和ST192。菌株的ST型、科室及时间分布显示,ST78-vanA VRE为我院主要流行菌株。结论我院分离的VRE对万古霉素高水平耐药,均为vanA型耐药基因介导;MLST分型较为集中,存在克隆传播,应加强耐药监测及院内感控工作。Objective To analyze the drug resistance and molecular epidemicology of vancomycin-resistant Enterococcus(VRE)in the past ten years.Methods The clinical isolates of vancomycin-resistant Enterococcus were collected in 2010^-2019.Identification and drug sensitivity test were performed by VITEK2-compact automatic bacteria identification system.Van genotyping was performed by multiple polymerase chain reaction.Multilocus sequence typing(MLST)was used for molecular typing.Results A total of 4564 strains of Enterococcus were isolated during the 10 years,and the VRE strains were 29.VRE strains were resistant to many antibiotics,all of which were vanA type.Seven MLST types were identified in the 29 strains,including ST78(n=19),ST17(n=5),and one each for ST18,ST389,ST80,ST564 and ST192.In terms of department and time distribution,ST78-vanA VRE strain was the main prevalent strain in our hospital.Conclusion The VRE strains isolated in our hospital showed high resistance to vancomycin,all of which were vanA genes.And the MLST types were concentrated.Drug resistance monitoring and hospital infection control should be strengthened.

关 键 词：万古霉素 肠球菌 耐药 多位点序列分型 万古霉素耐药肠球菌 

分 类 号：R978.1[医药卫生—药品]