万古霉素耐药肠球菌及Ⅰ类整合子基因的检测与分析

Detection and analysis of vancomycin-resistant enterococci and Ⅰ integron in enterococci

目的:统计中日友好医院肠球菌耐药情况,对万古霉素耐药肠球菌(VRE)进行筛查,检测Ⅰ类整合子基因,为肠球菌感染的药物治疗和控制提供参考。方法:药敏采用微量肉汤稀释法检测最低抑菌浓度(MIC),WHONET 5.3统计耐药率;万古霉素确证试验筛查VRE,多重聚合酶链反应(PCR)法检测其van基因,Etest法测定万古霉素、替考拉宁对VRE的MIC;PCR检测Ⅰ类整合子基因。结果:肠球菌对多种抗菌药物耐药程度很高;449株肠球菌中有6株检出vanC1基因,表型和基因型一致;未检出Ⅰ类整合子基因。结论:肠球菌耐药严重,需采取有效措施预防和控制VRE感染与传播,VRE筛查未见Ⅰ类整合子基因介导的耐药机制。

Objective：To offer references for drug therapy and prevention of enterococci infection,we summarized the antimicrobial resistance of enterococci separated from China-Japan Friendship Hospital from Jan 2002 to Dec 2005.To investigate the antimicrobial resistance mechanism of enterococci,we detected van gene and I integron.Methods：MIC was determined with microdilution broth method for drug susceptibility of enterococci. R were summarized with WHONET 5.3. Screening test was used for vancomycin resistance enterococci. Van gene were detected with multiplux PCR and further confirmed by DNA sequencing.Etest were used to determine the susceptibility of vancomycin-resistant enterococci （VRE）s to vancomycin and teicoplanin.I integron was detected with PCR as well.Results：Enterococci in the hospital showed resistant to many antimicrobial agents.Six VanC1 were determined in 449 enterococci and the phenotypes were consistent to their genetypes. No I integron was found in 40 enterococci in the study.Conclusion：Drug resistance in enterococci is serious in this hospital. It is necessary to take measures to prevent and control VRE infection and transmission in hospital. No I integron participated in the drug resistance mechanism of enterocci in this study.