万古霉素耐药肠球菌基因分型及耐药性分析

Genotype and drug resistance of Vancomycin resistant Enterococci

目的了解本地区万古霉素耐药肠球菌(Vancomycin resistant Enterococci,VRE)耐药基因型别及耐药性,为临床治疗提供依据。方法用PCR方法检测56株VRE的耐药基因vanA、vanB、vanC、vanD、vanE和vanG;用K-B法检测其对临床常用14种抗菌药物的药敏,并用肉汤稀释法检测万古霉素和替考拉宁的药敏。结果 56株VRE中,vanA阳性的43株;vanB、vanC、vanD、vanE和vanG阳性0株;未检测到万古霉素耐药相关基因的13株。2011-2014年万古霉素和替考拉宁的MIC值呈逐年向左漂移趋势,与同期替考拉宁的使用有关。结论本研究所收集VRE对万古霉素的耐药大部分为高水平耐药,所携带的耐药基因类型主要为vanA,另有其他未知基因型以及少数vanA阳性但是表现为万古霉素敏感菌株。

Objective To learn the genotype of drug resistance of Vancomycin resistant Enterococci spp.（VRE）in the local region,and provide guidance for clinical treatment.Methods The drug resistant genes vanA,vanB,vanC,vanD,vanE and vanG of 56 VRE strains were detected with PCR method.The susceptibility to 14 commonly used antimicrobial drugs were tested with K-B method,and the sensitivity to Vancomycin and Teicoplanin were detected with broth dilution method.Results 43 out of the 56 VRE strains were vanA positive;no strains were vanB,vanC,vanD,vanE or vanG positive.13 strains were not found carrying Vancomycin resistant genes.The MIC values of Vancomycin and Teicoplanin drifted to the left year by year during 2011-2014,which was related to the use of teicoplanin in corresponding period.Conclusion Most of the VRE strains collected in this study are highly resistant to Vancomycin,carrying resistant gene vanA.There are other unknown genotypes and a fewvanA positive but Vancomycin-sensitive strains.