第 15 卷 第 4 期 北华大学学报(自然科学版) Vol.15 No.4
2014 年 8 月 JOURNAL OF BEIHUA UNIVERSITY(Natural Science) Aug.2014
文章编号:1009-4822(2014)04-0482-04 DOI:10.11713/ j.issn.1009-4822.2014.04.014
肠球菌临床耐药性分析
及耐药基因 vanM 在屎肠球菌中的检测
刘晓薇,孙 贺,李咏梅
(北华大学基础医学院,吉林 吉林 132013)
摘要:目的 了解肠球菌临床分离株耐药性及 vanM 基因在屎肠球菌的分布情况,为临床合理用药及探讨耐药机
制提供依据.方法 采用 VITEK60 全自动微生物分析仪对肠球菌进行鉴定及药敏试验,按 NCCLS/ CLSI 标准判
断并统计分析结果;PCR 法检测耐万古霉素、替考拉宁菌株中的耐药基因 vanM,并对阳性基因进行测序,分析耐
药基因与耐药性的关系.结果 临床分离肠球菌共 506 株,其中屎肠球菌 277 株,粪肠球菌 229 株.尿液标本来源
比例最高,为 167 株(33%);粪便标本 114 株(22.5%);痰液标本 78 株(15.4%);胆汁标本 57 株(11.3%);脓液标
本 54 株(10.7%) ;其他来源 36 株(7.1%) .药敏结果显示:肠球菌对大部分临床抗菌药高度耐药,屎肠球菌对 β-
内酰胺类抗菌药物(氨苄西林)、喹诺酮类(左氧氟沙星)、糖肽类(万古霉素、替考拉宁) 的耐药率明显高于粪肠
球菌(P<0.05) .vanM 基因在耐万古霉素菌株中的检出率为 100%,耐替考拉宁菌株检出率为 90%.结论 屎肠球
菌可引起临床各类感染,屎肠球菌对大多数抗生素的耐药率明显高于粪肠球菌,且呈多重耐药趋势.vanM 基因
可能在糖肽类药物万古霉素、替考拉宁耐药机制中发挥重要作用.
关键词:屎肠球菌;耐药;vanM 基因
中图分类号:R378.1 文献标志码:A
收稿日期:2014-03-29
基金项目:吉林省科技发展计划项目(20110921).
作者简介:刘晓薇(1986
-
),女,硕士研究生,主要从事病原生物学研究;
通信作者:李咏梅(1964
-
),女,教授,博士,硕士生导师,主要从事病原微生物致病与耐药机制研究.
Analysis on Enterococcal Clinical Resistance and Detection of New
Resistance Gene vanM in Enterococcus faecium
Liu Xiaowei,Sun He,Li Yongmei
(Fundamental Medical College of Beihua University,Jilin 132013,China)
Abstract: Objective To investigate the antibiotic resistance of isolated Enterococcus spp.and the distribution of
gene vanM in Enterococcus faecium. Methods VITEK60 automatic microorganism analyzer was used to conduct
identification of Enterococci and drug sensitive test,and the results were calculated and analyzed according to the
standard of NCCLS / CLSI;Glycopeptide drug resistance gene vanM was detected by PCR and the sequence of
positive gene was measured for analyzing the relationship between the resistance gene and the resistance.Results
506 Enterococcus isolates,there were 277 isolates of Enterococcus faecium and 299 isolates of Enterococcus
faecalis.The sample resources included urine 167(33.0%),stool 114(22.5%),sputum 78(15.4%),bile 57(11.
3%),pus 54 ( 10. 7%) and others 36 ( 7. 1%) respectively. The drug sensitive test results showed that
Enterococcus had a high antibiotic resistance to most antibiotics;the resistance rate of Enterococcus faecium to β-
lactams( ampicillin),quinolones( levofloxacin) and glycopeptide( vancomycin and teicoplanin) antibiotics was
significantly higher than that of Enterococcus faecalis(P<0.05);the detectable rate of vanM fragment was 100%
and that of teicoplanin-resistant isolates was 90%. Conclusions Enterococcus faecium can cause all kinds of
clinical infection and its resistant rate is significantly higher than that of Enterococcus faecalis,showing a multiple
drug resistance trend. vanM gene may play an important role in the resistance mechanisms to glycopeptide
antibiotics,vancomycin and teicoplanin.
Keywords: Enterococcus faecium;resistance;vanM