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[1]朱宏,高硕,周辉,等.尿路感染中肠球菌耐药性及毒力基因分析[J].医学研究与战创伤救治(原医学研究生学报),2019,21(5):466-469.[doi:10.3969/j.issn.1672-271X.2019.05.004]
　ZHU Hong,GAO Shuo,ZHOU Hui,et al.Analysis of drug resistance and virulence genes of enterococci isolated from urinary tract[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2019,21(5):466-469.[doi:10.3969/j.issn.1672-271X.2019.05.004]
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尿路感染中肠球菌耐药性及毒力基因分析()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第21卷
期数:
2019年5期
页码:
466-469
栏目:
临床研究
出版日期:
2019-09-06

文章信息/Info

Title:
Analysis of drug resistance and virulence genes of enterococci isolated from urinary tract
文章编号:
1672-271X（2019）05-0466-04
作者:
朱宏;  高硕;  周辉;  张之烽;  沈瀚;  张燕;  周万青
作者单位：210008南京，南京大学医学院附属鼓楼医院检验科（朱 宏、高 硕、周 辉、张之烽、沈 瀚、张 燕、周万青）
Author(s):
ZHU Hong;  GAO Shuo;  ZHOU Hui;  ZHANG Zhi-feng;  SHEN Han;  ZHANG Yan;  ZHOU Wan-qing
(Department of Laboratory Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008,Jiangsu,China)
关键词:
肠球菌;  耐药性;  毒力基因;  尿路感染
Keywords:
enterococci;  drug resistance;  virulence genes;  urinary tract infection
分类号:
R446.5
DOI:
10.3969/j.issn.1672-271X.2019.05.004
文献标志码:
A
摘要:
目的 研究尿路感染中肠球菌的耐药性及毒力基因携带情况。 方法 收集临床中段尿分离肠球菌88株（包括41株粪肠球菌和47株屎肠球菌），采用微量肉汤稀释法和纸片扩散法检测菌株的药物敏感性；PCR法检测肠球菌6种毒力基因cylA、esp、asal、hyl、gelE和agg。 结果 粪肠球菌对红霉素耐药率较高（70.73%），对其他检测抗生素的耐药率均低于35%，检出利奈唑胺耐药菌株1株。屎肠球菌对青霉素、氨苄西林、左氧氟沙星的耐药率较高（分别为95.74%、95.74%、93.62%），对红霉素、环丙沙星、莫西沙星的耐药率接近90%，对其他检测药物耐药率较低。屎肠球菌对青霉素、氨苄西林、喹诺酮类及呋喃妥因的耐药率明显高于粪肠球菌（P<0.05）。所有检测菌株中呋喃妥因耐药率明显高于磷霉素（21.59% vs 1.14%，P<0.05）。41株粪肠球菌中均检出毒力基因，以gelE、asal、esp和cylA为主，未检出hyl基因；47株屎肠球菌中40株检出毒力基因，其中仅检出esp和hyl 2种毒力基因，未检出其他4种毒力基因。粪肠球菌中cylA、asal、gelE和agg毒力基因的携带率均明显高于屎肠球菌（P<0.05），hyl基因携带率则明显低于屎肠球菌（P<0.05）。 结论 尿路感染中屎肠球菌较粪肠球菌具有更高的耐药性，而粪肠球菌携带的毒力基因更多，磷霉素在尿路感染肠球菌中具有较低的耐药。
Abstract:
Objective To study the drug resistance and virulence gene of Enterococci isolates obtained from urinary tract. Methods 88 Enterococci strains （including 47 strains of E.faecium and 41 strains of E.faecalis） were isolated from clinical midstream urine samples.The drug sensitivity were detected by broth dilution and disk diffusion methods. Six toxic genes cylA, esp, asal, hyl, gelE and agg of enterococcus faecalis were detected by PCR. Results The resistance rate of E.faecalis to erythromycin was 70.73%, while less than 35% to other antibiotics detected, and one linezolid-resistant strain was detected. The resistance rate of E.faecium to penicillin, ampicillin, and levofloxacin were 95.74%,95.74% and 93.62%, respectively. The resistance rate to erythromycin, ciprofloxacin and moxifloxacin was close to 90%, while the resistance rate to other tested drugs was low.The resistance rate of E.faecium to penicillin, ampicillin, quinolones and furantoids were significantly higher than those of E.faecalis (P<0.05).The resistance rate of furantoin was significantly higher than that of phosphorubicin in all 88 tested strains (21.59 % vs 1.14 %, P<0.05).Virulence genes were detected in 41 stains of E.faecalis, with mainly gelE, asal, esp and cylA, but no hyl gene detected. Forty strains of 47 E.faecium were detected with virulence genes, in which only esp and hyl were detected. The virulence genes of cylA, asal, gelE, and agg detected in E.faecalis were significantly higher than those in E.faecium (P<0.05), while the detection rate of hyl gene in E.faecalis was significantly lower than that in E.faecium (P<0.05). Conclusion The drug resistance rate of E.faecium isolated from urinary tract was higher than that of E.faecalis, while the rate of virulence gene carried by E.faecalis was higher than that of E.faecium. Phosphoromycin has low resistance in urinary tract infection with Enterococcus.

参考文献/References:

1 王立，刘长庭.临床肠球菌属耐药特点和毒力基因的研究进展[J].检验医学与临床，2014,11(9):1259-1261.
2 HollenbeckBL, RiceLB.Intrinsic and acquired resistance mechanisms in enterococcus[J]. Virulence, 2012, 3(5):421-433.
3 SalminenS, Von WrightA.Lactic acid bacteria:microbiological and functional aspects[M]. 3 rd ed. Virginia:CRC Press, 2004:396.
4 Clinical and Laboratory Standards Institute.Performance standards for antimicrobial susceptibility testing, 27th informational supplement (M100-S27)[S]. Wayne, PA:CLSI, 2017.
5 祝进,白永凤,陆军,等.粪肠球菌毒力基因及耐药性分析[J].放射免疫学杂志，2012，25(3):276-279.
6 李东冬,沈定霞,郭玲,等.血液分离肠球菌毒力基因检测及生物膜形成测定[J].中华微生物学和免疫学杂志,2013, 33(11):865-867.
7 魏泽庆,沈萍,陈云波,等.Mohnarin 2010年报告:血流感染细菌构成及耐药性分析[J].中华医院感染学杂志,2012,22(3):465-570.
8 王文娟，马承泰，纪方方，等.肠球菌致尿路感染的院内分布特点与耐药性分析[J].实用医药杂志，2017,6(34):501-505.
9 高岚美，潘玉红，邹红，等.中段尿培养215株肠球菌耐药性分析[J].海峡预防医学杂志，2016,22(1):105-107.
10 王效雷,罗婕,丁兆霞,等.119例导尿管相关性尿路感染的病原体分布及耐药性分析[J].东南国防医药,2015,17(1):46-48.
11 石晓卉,刘琪,于湘友.外科重症监护室临床细菌分布及耐药性监测[J].东南国防医药,2014,16(4):349-352.
12 宋娟，华川.临床感染粪肠球菌致病岛毒力相关基因的研究现状[J].西南军医，2015,17(4):422-425.
13 黄小丽，赵瑞珂，李艳萌，等.医院获得性尿路感染肠球菌耐药性与毒力基因型相关研究[J].检验医学与临床，2015,12(21):3140-3143.
14 陆君卓，程磊.持留菌的控制与清除研究进展[J].医学研究生学报，2018,31(1):77-82.

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备注/Memo

备注/Memo:
收稿日期：2019-01-22
更新日期/Last Update: 2019-09-06