| 钱纯，宁兴旺.肠球菌耐药性与耐万古霉素基因初步检测.[J].中南医学科学杂志.,2011,39(4):422-425. |
| 肠球菌耐药性与耐万古霉素基因初步检测 |
| Detection of Enterococci Resistance and Vancomycin Resistant Gene |
| 投稿时间：2010-09-06 |
| DOI： |
| 中文关键词: 肠球菌 耐药性 耐万古霉素肠球菌 基因型 |
| 英文关键词:eterococcus resistance vncomycin-rsistant eterococci genotype |
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| 摘要点击次数: 890 |
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| 中文摘要: |
| 目的了解肠球菌对六种常用抗生素的耐药情况，同时检测耐万古霉素肠球菌（VRE）的耐万古霉素基因型。方法用K-B纸片琼脂扩散法检测肠球菌对万古霉素、替考拉宁、氨苄西林、氨苄西林/舒巴坦、环丙沙星以及庆大霉素等六种常用抗生素的敏感性。采用含6 μg/mL万古霉素的琼脂稀释筛选平板法（ADSP）筛选VRE菌株，并用多重聚合酶链反应(multiplex-PCR)检测VRE的耐万古霉素基因型。结果100株临床分离肠球菌中以粪肠球菌（86%）和屎肠球菌（11%）为主。除万古霉素和替考拉宁外，屎肠球菌对其它几种抗生素的耐药率明显高于粪肠球菌（P<0.05）；庆大霉素高耐株检出率为54%，其对常用抗生素的耐药率明显高于低耐株（P<0.05）。用ADSP法筛选出3株（3%）耐万古霉素肠球菌，其中只有一株铅黄肠球菌为耐万古霉素基因型阳性（VanC2），其余两株均为Van基因阴性。结论ADSP法用于筛选VRE较K-B法检出率高；本次研究只分离出一株VanC2型VRE，没有发现具有重要临床意义的VanA和VanB型VRE；肠球菌对庆大霉素（120 μg/片）的耐药率为54%，建议临床慎用；万古霉素、替考拉宁、氨苄西林及氨苄西林/舒巴坦均可作为治疗粪肠球菌感染的药物，但需密切注意肠球菌耐药情况。 |
| 英文摘要: |
| ObjectiveTo study the resistance of Enterococci to commonly used antibiotics and detect the genotypes of Vancomycin-Resistant Enterococci (VRE).MothedsDrug resistance of Enterococci to vancomycin,teicoplanin,ampicillin,ampicillin/sulbactam,ciprofloxacin and gentamycin were detected by disc agar diffusion method.VRE were screened by agar dilution sieving plate (ADSP) containing 6 μg/mL of vancomycin,and their genotypes were determined using multiplex PCR.ResultsAmong the 100 isolated strains of Enterococci,E.faecalis (86%) and E.faecium (11%) were the majority.The resistance rate of E.faecium was significantly higher than those of E.faecalis (P<0.05),except for vancomycin and teicoplanin.With ADSP,3 VRE were screened from the 100 isolated Enterococci.With multiplex PCR,only one strain was determined as VanC2,and the others were negative.ConclusionsADSP is more sensitive than K-B method for VRE screening.Unfortunately,we didnt find any relevant genotype of VanA and VanB,but one strain of VanC2.The resistance rate of hyper-concentration gentamycin reached to 54%,indicating the cautious implement in clinic.Vancomycin,teicoplanin and ampicillin are effective drugs for Enterococcus infection,but close surveillance for the resistance of Enterococci is essential. |
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