临床分离α和β溶血性粪肠球菌质谱特征和毒力基因及耐药性  

Mass spectrometry characteristics, virulence genes and drug resistance of clinical Enterococcus faecalis isolates with α and β hemolytic phenotypes

作　　者：高晶晶[1] 王亚南[1] 张晓倩 黄蓝 徐卫东[1] 付婷 GAO Jing-jing;WANG Ya-nan;ZHANG Xiao-qian;HUANG Lan;XU Wei-dong;FU Ting(The Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou Municipal Hospital,Suzhou,Jiangsu 215002,China;不详)

机构地区：[1]南京医科大学附属苏州医院,苏州市立医院检验医学中心,江苏苏州215002 [2]丰县人民医院检验科,江苏徐州221700 [3]南京医科大学附属苏州医院,苏州市立医院妇科,江苏苏州215002

出　　处：《中华医院感染学杂志》2025年第2期188-192,共5页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金项目(82302626);苏州市应用基础研究科技创新项目(SYWD2024326);苏州市科技发展计划项目(SKYD2023037);苏州市“科教兴卫”青年科技项目(KJXW2021043);南京医科大学齐鲁临床研究基金项目(2024KF0258)。

摘　　要：目的 研究临床分离不同溶血表型粪肠球菌的质谱特征、毒力基因携带情况和耐药性。方法 收集2016-2022年南京医科大学附属苏州医院临床患者分离的非重复α溶血性与β溶血性粪肠球菌各50株。采用基质辅助激光解吸电离飞行时间质谱(MALDI-TOF MS)和CinProTools软件对所有菌株进行检测和质谱谱峰分析。采用肉汤稀释法和纸片扩散法(K-B)检测分离菌株对常用抗菌药物的敏感性。采用聚合酶链反应(PCR)法和基因测序检测菌株毒力基因cylB、cylM、cylA、cylL1、gelE、agg、ace、esp和efaA的携带情况。结果 两种溶血表型的粪肠球菌在血琼脂平板上的溶血性均可稳定遗传。在质谱特征上,质荷比为4 731、3 199、7 058、6 701 m/z的质谱峰是区分两组细菌最主要的差异峰,其对应的受试者工作特征曲线下面积分别为0.956、0.941、0.910、0.908。在毒力基因表达上,两种表型粪肠球菌efaA基因携带率均为100.00%,ace和gelE基因在α溶血性粪肠球菌中携带率明显高于β溶血性粪肠球菌(P<0.05)。在耐药性方面,α溶血性粪肠球菌对青霉素和环丙沙星的耐药率明显高于β溶血性粪肠球菌(P<0.05),对米诺环素的耐药率明显低于β溶血性粪肠球菌(P<0.05)。所有菌株均未检出万古霉素和替考拉宁耐药菌株。结论 不同溶血表型的粪肠球菌在质谱特征峰、毒力基因携带率和耐药性上表现出差异,临床应对细菌耐药及相关毒力因子进行动态监测。OBJECTIVE To observe the mass spectrometry characteristics,virulence genes and drug resistance in the clinical isolates of Enterococcus faecalis with different hemolytic phenotypes.METHODS Totally 50 strains of non-repetitive alpha(α)-hemolytic E.faecalis and 50 strains of beta(β)-hemolytic E.faecalis were isolated from the patients who were treated in the Affiliated Suzhou Hospital of Nanjing Medical University from 2016 to 2022.All of the strains were detected,and the mass spectrometry peaks were analyzed by means of matrix-assisted laser desorption ionization time-of-flight mass spectrometry(MALDI-TOF MS)and ClinProTools.The drug susceptibility testing for the commonly used antibiotics was carried out by using broth dilution method and disc diffusion method(K-B).The carrying rates of virulence genes cylB,cylM,cylA,cylL1,gelE,agg,ace,esp and efaA in the strains were detected by polymerase chain reaction(PCR)and gene sequencing.RESULTS The hemolytic properties of both hemolytic phenotypes of E.faecalis could be stably inherited on blood agar plates.As for the mass spectrometry characteristics,the mass-to-charge ratio(m/z)peaks of 4731,3199,7058,and 6701 m/z were the main differences that distinguished the two groups of bacteria,and the corresponding areas under the receiver operating characteristic curves were 0.956,0.941,0.910 and 0.908,respectively.In terms of the expressions of virulence genes,the carrying rate of efaA was 100.00%in both of the two phenotypes of E.faecalis;the carrying rate of ace and gelE were significantly higher in theα-hemolytic E.faecalis strains than in the β-hemolytic E.faecalis strains(P<0.05).With the regard to the drug resistance,the drug resistance rates of the α-hemolytic E.faecalis strains to penicillin and ciprofloxacin were significantly higher than those of the β-hemolytic E.faecalis strains(P<0.05);while the drug resistance rate of the α-hemolytic E.faecalis strains to minocycline was significantly lower than that of the β-hemolytic E.faecalis strains(P<0.05).No strai

关 键 词：粪肠球菌 溶血表型 毒力基因 耐药性 

分 类 号：R378.1[医药卫生—病原生物学]