临床分离肠球菌属对万古霉素耐药基因的检测及分子流行病学研究

Detection of Vancomycin-resistant Genes of Enterococcus in Clinic and Their Molecular Epidemiology

目的了解临床分离肠球菌属对万古霉素的敏感性,并对糖肽类耐药基因型别及菌株同源性进行研究。方法琼脂稀释法测定72株肠球菌属对万古霉素敏感性,PCR检测万古霉素中敏肠球菌属中vanA、vanB、vanC1和vanC2基因存在情况,ERIC-PCR进行同源性分析。结果10株万古霉素中敏肠球菌属对其他临床常用抗菌药物耐药率均>50%,而对替考拉宁、利奈唑胺的耐药率为0;2株vanC2基因阳性,未发现vanA、vanB基因;ERIC-PCR结果显示,10株万古霉素中敏肠球菌属分为8型,其中A型(3株)来自同一所医院。结论万古霉素不敏感肠球菌属显示多药耐药,但对替考拉宁和利奈唑胺敏感,部分菌株vanC2基因阳性,可能存在菌株间的克隆传播。

OBJECTIVE To investigate the sensitivity to vancomycin of Enterococcus in clinic and the genotype and homology of glycopeptides-resistant strains. METHODS The sensitivity to vancomycin in 72 enterococci strains was detected with agar dilution; the existence of vanA, vanB, vanC1 and vanC2 in enteroeocci was detected by PCR and ERIC-PCR. RESULTS More than 50 % of enterococci intermediated to vancomycin were resistant to other antimicrobial agents commonly used in clinic, except for teicoplanin and linezolid. Gene of vanC2 was present in two strains, but none with vanA and vanB. The ten strains of enterococci intermediated to vancomycin were divided into eight types, in which type A （3 strains） was isolated from the same hospital. CONCLUSIONS Multidrug resistance is observed in enterococci resistant to vancomycin, which are sensitive to teieopianin and linezolid. Gene of vanC2 is found in some of them, suggesting clone transmission happen among strains.