上海某三级医院重症监护室尿路感染分离肠球菌特征性分析  

Characteristic Analysis of Enterococci from Urinary Tract Infection in Intensive Care Units of A Tertiary Hospital in Shanghai

作　　者：张婷 袁轶群 陈甲龙 李刚 陈哲 Zhang Ting;Yuan Yiqun;Chen Jialong(Department of Laboratory Medicine,Jinshan Hospital of Fudan University,Shanghai 201508,China)

机构地区：[1]复旦大学附属金山医院检验科,上海201508

出　　处：《四川医学》2025年第4期433-437,共5页Sichuan Medical Journal

基　　金：复旦大学附属金山医院科学技术研究项目(编号:2018-JSYYKT-05)。

摘　　要：目的探讨重症监护病房尿路感染病例中分离的肠球菌的耐药表型与毒力基因分布特征,为临床尿路感染抗菌药物的选择提供参考。方法收集重症监护病房2019年1月至2020年12月的尿路感染患者清洁中段尿标本分离的肠球菌并进行鉴定,采用纸片扩散法(K-B法)和E-test试纸条检测菌株的药物敏感性;多重PCR方法检测肠球菌8种毒力基因fsr、efm、esp、cylA、cad1、ace、gelE和asa1。结果54株菌株中,有41株屎肠球菌(75.9%),13株粪肠球菌(24.1%)。屎肠球菌对氨苄西林、左氧氟沙星的耐药率分别为97.6%、100.0%,相比于粪肠球菌更高。屎肠球菌fsr、efm、esp、cylA、cad1、ace、gelE和asa1毒力基因的阳性率分别为0、100.0%、97.6%、0、100.0%、0、0和0;粪肠球菌8种毒力基因的阳性率则为30.8%、0、84.6%、84.6%、100.0%、100.0%、69.2%和84.6%。结论屎肠球菌是重症监护病房医院获得性尿路感染的主要病原体,与粪肠球菌相比,其携带更多的毒力基因。Objective The study aims to explore the drug resistance phenotype and virulence gene distribution characteristics of enterococci isolated from urinary tract infection cases in intensive care units,providing references for the selection of antimicrobial agents in clinical practice.Methods Enterococci were collected and identified from clean midstream urine samples of patients with urinary tract infections in the ICU from January 2019 to December 2020.The antimicrobial susceptibility of the strains was conducted by the Kirby-Bauer(K-B)disk diffusion method and E-test strips.Eight virulence genes of fsr,efm,esp,cylA,cad1,ace,gelE and asa1 were detected by Multiplex PCR.Results Among the 54 strains,there were 41 strains of Enterococcus faecium(75.9%)and 13 strains of Enterococcus faecalis(24.1%).The resistance rates of Enterococcus faecalis to ampicillin and levofloxacin were 97.6%and 100.0%,respectively,which were higher than those of Enterococcus faecalis.The positive rates of fsr,efm,esp,cylA,cad1,ace,gelE and asa1 in Enterococcus faecium were 0,100.0%,97.6%,0,100.0%,0,0,0,while those were 30.8%,0,84.6%,84.6%,100.0%,100.0%,69.2%and 84.6%in Enterococcus faecalis,respectively.Conclusion Enterococcus faecium is the main pathogen of hospital acquired urinary tract infections in intensive care units,carrying more virulence genes compared to Enterococcus faecalis.

关 键 词：尿路感染 屎肠球菌 粪肠球菌 耐药性 毒力基因 

分 类 号：R446.12[医药卫生—诊断学]