肝胆外科患者感染肠球菌耐药基因与毒力基因检测

Detection of drug resistance genes and virulence genes in Enterococcusinfecting patients in Hepatobiliary Surgery

目的检测肝胆外科患者感染肠球菌的耐药基因与毒力基因分布情况,为控制肠球菌的耐药性提供指导。方法分离自本院肝胆外科住院患者送检标本的肠球菌289株,用药敏分析卡进行药敏试验,并对其耐药基因和毒力基因进行PCR检测。结果药敏试验显示分离菌对氨苄西林、红霉素、青霉素、庆大霉素、链霉素、替考拉宁、万古霉素的耐药率分别为100.00%、92.39%、82.35%、74.74%、44.29%、6.23%和13.15%。PCR扩增目的基因,其中hyd基因扩增片段大小为578bp,vanB基因为635bp,ant(6′)-I基因为597bp,psaA基因为540bp,esp基因为539bp,cylB基因为522bp,erm基因为616bp,vanA基因为732bp,tem基因为332bp,aac(6′)-aph(2′′)基因为348bp,上述基因在肠球菌临床分离株中的阳性率分别为93.08%、22.15%、15.22%、36.68%、74.74%、44.98%、16.96%、28.03%、19.03%和22.15%。结论 vanA基因和vanB基因的存在使得肠球菌对万古霉素耐药,van基因的存在使得肠球菌对替考拉宁耐药,aac(6′)-aph(2′′)基因的存在使得肠球菌对庆大霉素耐药,ant(6′)-I基因的存在使得肠球菌对链霉素耐药,erm基因的存在使得肠球菌对红霉素耐药,tem基因的存在使得肠球菌对青霉素和氨苄西林耐药。此外,肠球菌毒力基因的分布情况可能也与其耐药性有关联。

Objective Drug resistance genes and virulence genes in Enterococcus infecting patients in Hepatobiliary Sur- gery were detected to provide guidance to control the drug resistance of Enterococcus. Methods Laboratory samples from patients in Hepatobiliary Surgery at this hospital were collected, and 289 strains of Enterococcus were isolated. A planin and vancomycin, and highly resistant to other antibiotics. Amplification of target genes with PCR revealed that the hyd gene was 578 bp in length, the vanB gene was 635 bp, the ant （6r）-I gene was 597 bp, the psaA gene was 540 bp, the esp gene was 539 bp, the cylB gene was 522 bp, the erm gene was 616 bp, the vanA gene was 732 bp, the tern gene was 332 bp, and the aac（6＇）-aph（2＇r） gene was 348 bp. The erm drug resistanee gene was detected in 93. 080//oo of the clinical isolates of Enterococcus, the vanA gene was detected in 22.15%, the vanB gene was detected in 15.22%, the tern gene was detected in 36.68%, the aae（6′）-aph（2″） gene was detected in 74.74%, the ant（6′）-I gene was detected in 44.98%, the cylB gene was detected in 16.96%, the esp gene was detected in 28.03%, the psaA gene was detected in 19.03%, and the hyd gene was detected in 22.15%. Conclusion Enterococcus was resistant to vancomycin due to the presence o{ the vanA gene and the vanB gene, it was resistant to teicoplanin due to the presence of the vanA gene, it was resistant to gentamicin due to the presence of the aac（6′）-aph（2″） gene, it was resistant to erythromycin due to the pres- ence of the ant（6′）-1 gene, it was resistant to streptomycin due to the presence of the erm gene, and it was resistant to penicillin and ampicillin due to the presence of the tem gene. The distribution of virulence genes in Enterococcus might berelated to the drug resistance of enterococei.