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[1]牛冬梅,宋佳希,周万青,等.尿路分离利奈唑胺不敏感粪肠球菌耐药机制及毒力基因研究[J].医学研究与战创伤救治(原医学研究生学报),2022,24(1):23-26.[doi:10.3969/j.issn.1672-271X.2022.01.005]
　NIU Dong-mei,SONG Jia-xi,ZHOU Wan-qing,et al.Resistance mechanism and virulence genes of linezolid insensitive Enterococcus faecalis isolated from urinary tract[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2022,24(1):23-26.[doi:10.3969/j.issn.1672-271X.2022.01.005]
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尿路分离利奈唑胺不敏感粪肠球菌耐药机制及毒力基因研究()
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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24卷
期数:
2022年1期
页码:
23-26
栏目:
临床研究
出版日期:
2022-02-20

文章信息/Info

Title:
Resistance mechanism and virulence genes of linezolid insensitive Enterococcus faecalis isolated from urinary tract
作者:
牛冬梅; 宋佳希; 周万青; 刘兴全
作者单位：210001南京，南京中医药大学附属南京中医院检验科（牛冬梅、宋佳希、刘兴全）；210008 南京，南京大学医学院附属鼓楼医院检验科（周万青）
Author(s):
NIU Dong-mei;  SONG Jia-xi;  ZHOU Wan-qing;  LIU Xing-quan
(1. Department of Clinical Laboratory,Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing 210001, Jiangsu，China; 2. Department of Clinical Laboratory, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu，China)
关键词:
粪肠球菌; 利奈唑胺; 耐药机制; 毒力基因
Keywords:
E. faecalis;  linezolid;  resistant mechanism;  virulence gene
分类号:
R446.5
DOI:
10.3969/j.issn.1672-271X.2022.01.005
文献标志码:
A
摘要:
目的探讨尿液分离利奈唑胺（LZD）不敏感粪肠球菌耐药机制及毒力基因携带情况。方法收集临床中段尿分离粪肠球菌72株，其中利奈唑胺不敏感和敏感菌株分别为23株和49株。采用微量肉汤稀释法检测菌株对常规药物最低抑菌浓度（MIC）；采用E-test复核利奈唑胺MIC。采用PCR法结合Sanger测序技术检测23株利奈唑胺不敏感粪肠球菌optrA基因、cfr基因及23S rRNA V区。采用PCR法检测肠球菌6种毒力基因cylA、esp、asa1、hyl、gelE和agg；统计分析LZD不敏感和敏感菌株毒力基因携带情况及差异。结果23株利奈唑胺不敏感粪肠球菌对利奈唑胺MIC分布4~256 μg/mL；其中13株检出optrA基因，其余10株未检出；23株菌未检出23S rRNA V区突变及cfr基因。23株LZD不敏感粪肠球菌中21株检出毒力基因，以asa1基因检出率最高（17/23，73.91%），其次为esp（16/23，69.57%）、cylA（13/23，56.52%）、gelE（10/23，43.48%）和agg（4/23，17.39%），未检出hyl基因；49株尿液分离LZD敏感粪肠球菌中48株检出毒力基因，以asa1基因检出率最高（42/49，85.71%），其次为cylA（39/49，79.59%）、esp（38/49，77.55%）、gelE（35/49，71.43%）和agg（10/49，20.41%），未检出hyl基因。利奈唑胺敏感菌株中cylA和gelE基因检出率均高于不敏感菌株，差异有统计学意义（χ2=4.15，5.22，P<0.05），其余基因检出率在2组间差异无统计学意义（P>0.05）。结论尿液分离利奈唑胺不敏感粪肠球菌中主要由optrA介导耐药；利奈唑胺不敏感粪肠球菌菌株cylA、gelE基因携带率低于敏感菌株。
Abstract:
ObjectiveTo investigate the resistance mechanism and virulence gene of linezolid insensitive Enterococcus faecalis (E. faecalis) isolated from urine.MethodsA total of 72 strains of E. faecalis were isolated from clinical urine samples. Among them, 23 strains were linezolid insensitive and 49 strains were linezolid sensitive. The minimal inhibitory concentration (MIC) of linezolid was checked by E-test. PCR combined with Sanger sequencing technique was used to detect the optrA gene, cfr gene and 23S rRNA V region of the 23 linezolid insensitive E. faecalis strains. Six virulence genes of enterococci including cylA, esp, asa1, hyl, gelE and agg were detected by PCR. And the difference of virulence genes between LZD insensitive and LZD sensitive strains was statistically analyzed.ResultsThe MIC distribution of linezolid was 4-256 μg/mL in 23 strains of linezolid insensitive E. faecalis. OptrA gene was detected in 13 strains, but not in the other 10 strains. 23S rRNA V region mutation and cfr gene were not detected in 23 strains. Among 23 strains of LZD insensitive E. faecalis, 21 strains were detected with virulence genes, of which asa1 gene was the highest (17/23, 73.91%), followed by esp (16/23, 69.57%), cylA (13/23, 56.52%), gelE (10/23, 43.48%) and agg (4/23, 17.39%), and without the expression of hyl gene. Among 49 strains of LZD sensitive E. faecalis, 48 strains were detected with virulence genes, of which asa1 gene was the highest (42/49), followed by cylA (39/49, 79.59%), esp (38/49, 77.55%), gelE (35/49, 71.43%) and agg (10/49, 20.41%). The detection rates of cylA and gelE genes in linezolid sensitive strains were higher than those in insensitive strains (χ2= 4.15, 5.22, P<0.05). There was no significant difference in the detection rate of other genes between the two groups (P>0.05).ConclusionThe resistance of linezolid insensitive E. faecalis isolated from urine is mainly mediated by optrA, and the carrying rate of cylA and gelE in linezolid insensitive strains is lower than that in linezolid sensitive strains.

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备注/Memo

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更新日期/Last Update: 2022-02-21