健康人群肠道中optrA阳性肠球菌的流行率及风险因素  

Prevalence and risk factors of optrA-positive Enterococcus in healthy human gut

作　　者：项秋梅 吕子全[2] 沈应博 汪洋[4] 沈建忠[4] 吴思英[1] 柯跃斌[2] XIANG Qiu-mei;LYU Zi-quan;SHEN Ying-bo;WANG Yang;SHEN Jian-zhong;WU Si-ying;KE Yue-bin(School of Public Health,Fujian Medical University,Fuzhou 350122,China;Key Laboratory of Molecular Epidemiology,Shenzhen Center for Disease Control and Prevention,Shenzhen 510873,China;CAS Key Laboratory of Pathogenic Microbiology and Immunology,Institute of Microbiology,Chinese Academy of Sciences,Bejing 10010l,China;College of Veterinary Medicine,China Agricultural University,Bejing 100193,China)

机构地区：[1]福建医科大学公共卫生学院,福州350122 [2]深圳市疾病预防控制中心分子流行病学研究室,深圳518073 [3]中国科学院微生物研究所病原微生物与免疫学重点实验室,北京100101 [4]中国农业大学动物医学院,北京100193

出　　处：《中华疾病控制杂志》2022年第11期1309-1314,共6页Chinese Journal of Disease Control & Prevention

基　　金：国家重点研发计划(2018YFD0500303);深圳市医学重点学科(SZXK066);食源性病原菌耐药性产生和传播机制及人类健康风险研究(JCYJ20170413101841798)。

摘　　要：目的 研究深圳市健康人群肠道携带optrA阳性肠球菌流行率及其风险因素。方法 共调取2018―2019年社区健康体检者粪便样本565份,采用肠球菌选择培养基筛选耐氟苯尼考肠球菌,使用MALDI-TOF MS(MALDI Biotyper,Bruker,Germany)进行种属鉴定及PCR鉴定optrA基因。以optrA阳性肠球菌的携带者作为病例,以年龄为匹配条件,按1∶4匹配未携带者作为对照。采用多因素logistic回归分析模型分析optrA阳性肠球菌定植于健康人群肠道的风险因素。结果 2018―2019年深圳市健康人群肠道中optrA基因的流行率为18.10%(102/565,95%CI:14.90%~21.20%),从基因阳性人群粪便中共分离447株optrA阳性肠球菌,粪肠球菌为最主要流行种属(76.06%)。猪肉日摄入量>50.0 g (OR=1.615,95%CI:1.017~2.565,P=0.042)、3个月内住院治疗(OR=11.551,95%CI:2.153~61.963,P=0.004)是optrA阳性肠球菌在健康人群肠道中定植的危险因素。结论 optrA阳性肠球菌在深圳市健康人群肠道中已广泛流行,其可能通过食物链传播至人类,同时住院治疗将增加optrA阳性肠球菌在健康人群肠道中定植的风险。Objective To investigate the prevalence and risk factors of optrA-positive Enterococcus in the healthy people in Shenzhen City.Methods A total of 565 feces of the healthy pepople during 2018-2019 was cultured on enterococcal-selective plates to obtain florfenicol-resistant Enterococcus.MALDI Biotyper,Bruker,Germany(MALDI-TOF MS) was used for the species identification and PCR was used for optrA gene confirmation.People carrying optrA-positive enterococci were defined as positive cases and four times people with optrA-negative were randomly selected as control cases using the age of matching condition.A multivariate logistic regression model was used to analyze the risk factors of optrA-positive Enterococcus colonization in the human intestines.Results Overall,the prevalence of optrA-positive individuals was 18.10%(102/565,95% CI:14.90%-21.20%) in Shenzhen during 2018-2019.A total of 447 optrA-enterococci strains was isolated from the above samples,of which the Enterococcus faecalis was the most prevalent species(76.06%).Pork intake >50 g/d(OR=1.615,95% CI:1.017-2.565,P=0.042) and hospitalization within 3 months(OR=11.551,95% CI:2.153-61.963,P=0.004) were risk factors for optrA-positive Enterococcus colonization in the healthy human intestines.Conclusions optrA-positive Enterococcus have been already widespread in the human intestines in Shenzhen,and these bacteria may spread to humans through the food chain.Meanwhile,hospitalization will increase the risk of optrA-positive Enterococcus colonizing in the healthy hunman intestines.

关 键 词：利奈唑胺 肠球菌 optrA 流行率 危险因素 

分 类 号：R181[医药卫生—流行病学]