尿路感染粪肠球菌耐药性与耐药基因相关性研究  

Correlational study between drug resistance and resistance genes of Enterococcus faecalis in urinary tract infection

作　　者：麦杏连 刘思瑶 陈旋 何倩君 张中文 钟国权[1] 温伟洪[1] 徐令清[1] Mai Xinglian;Liu Siyao;Chen Xuan;He Qianjun;Zhang Zhongwen;Zhong Guoquan;Wen Weihong;Xu Lingqing(The Sixth Affiliated Hospital of Guangzhou Medical University/Qingyuan People's Hospital,Qingyuan Guangdong 511518,China)

机构地区：[1]广州医科大学附属第六医院/清远市人民医院检验科,广东清远511518

出　　处：《中华临床实验室管理电子杂志》2021年第2期65-70,共6页Chinese Journal of Clinical Laboratory Management(Electronic Edition）

基　　金：广东省中医药局项目(20201407);广东省科技创新战略专项资金(DZXQY002);清远市人民医院医学科研基金支持项目(20190209);广东省医学科学技术研究基金(A2021490)(B2019187)。

摘　　要：目的对临床尿液标本中分离的粪肠球菌进行耐药基因与细菌耐药性分析,为粪肠球菌感染提供防治依据。方法对我院临床送检尿液标本中的粪肠球菌38株进行药敏分析,对Ⅰ类整合酶基因以及耐药基因(qacE△1-sull基因、tetM、ermB、aac(6′)/aph(2″)、aph3′Ⅲ、ant(6)Ⅰ、VanA、VanB)进行检测,阳性标本PCR产物进行测序分析及比对,并对耐药基因携带情况与耐药表型进行分析。结果38株粪肠球菌对12种抗生素耐药率从高到低为:红霉素(100%,38/38)、四环素(94.74%,36/38)、环丙沙星(47.37%,18/38)、左氧氟沙星(47.37%,18/38)、莫西沙星(44.74%,17/38)、高水平庆大霉素协同(31.58%,12/38)、呋喃妥因(5.26%,2/38)、氨苄青霉素(5.26%,2/38)、青霉素(5.26%,2/38)、利奈唑胺(2.63%,1/38)、万古霉素(0%)、替考拉宁(0%);耐药基因阳性率从高到低:tetM为92.11%(35/38)、qacE△1-sull为78.95%(31/38)、aph3′Ⅲ为71.05%(27/38)、aac(6′)/aph(2″)为44.74%(17/38)、ant(6)Ⅰ为34.21%(13/38),未检测出ermB基因、VanA基因、VanB基因和Ⅰ类整合子酶基因。结论粪肠球菌对临床常用药物具有不同程度耐药,多药耐药性与耐药基因携带有一定相关性,未检测到Ⅰ类整合子阳性菌株,可能与区域差异有关。Objective To study the relationship between bacterial drug resistance and resistance genes of Enterococcus faecalis isolated from urinary tract infection, so as to provide the prevention and treatment basis for Enterococcus faecalis infection. Methods 38 strains of Enterococcus faecalis with clinical urinary tract infection were collected and analyzed for drug sensitivity, the Ⅰ class integrase genes and drug resistant genes(qacE delta 1-sull gene, tetM, ermB, aac(6′)/aph(2′,′),aph3′Ⅲ, ant(6) Ⅰ, VanA, VanB) were detected. PCR products of positive samples were sequenced and analyzed, and the carrying status of drug-resistant genes and phenotypes were analyzed. Results The drug resistance rate of 38 strains of Enterococcus faecalis to 12 antibiotics was from high to low: E(100%, 38/38), TE(94.74%, 36/38), CIP(47.37%, 18/38), LVX(47.37%, 18/38), MXF(44.74%, 17/38),HLS(31.58%, 12/38), FM(5.26%, 2/38), AMP(5.26%, 2/38), P(5.26%, 2/38), LNZ(2.63%, 1/38), VA(0%), TEC(0%);The positive rate of drug-resistant genes ranged from high to low: the positive rate of tetM gene was 92.11%(35/38), the positive rate of qacE △ 1-sull gene was 78.95%(31/38), the positive rate of aph3′Ⅲ gene was 71.05%(27/38), aac(6′)/aph(2″) gene positive rate was 44.74%(17/38), ant(6)I gene positive rate was 34.21%(13/38), and 38 strains were not detected ermB gene, VanA gene, VanB gene and Ⅰ class integron enzyme gene. Conclusions The drug resistance rate of 38 strains of Enterococcus faecalis to 12 antibiotics was from high to low: E(100%, 38/38), TE(94.74%, 36/38), CIP(47.37%, 18/38), LVX(47.37%, 18/38), MXF(44.74%, 17/38), HLS(31.58%, 12/38), FM(5.26%, 2/38),AMP(5.26%, 2/38), P(5.26%, 2/38), LNZ(2.63%, 1/38), VA(0%), TEC(0%);The positive rate of drugresistant genes ranged from high to low: the positive rate of tetM gene was 92.11%(35/38), the positive rate of qacE △ 1-sull gene was 78.95%(31/38), the positive rate of aph3′Ⅲ gene was 71.05%(27/38), aac(6′)/aph(2″) gene positive rate was 44.74%(17/38), ant(6) Ⅰ

关 键 词：粪肠球菌 耐药基因 耐药性 整合子 

分 类 号：R446.5[医药卫生—诊断学]