中华检验医学杂志
中華檢驗醫學雜誌
중화검험의학잡지
CHINESE JOURNAL OF LABORATORY MEDICINE
2008年
9期
984-988
,共5页
汪玲%杨永弘%陆权%王艺%陈沅%邓力%邓秋莲%张泓%王传清%刘岚%徐樨巍%马耀玲%沈叙庄
汪玲%楊永弘%陸權%王藝%陳沅%鄧力%鄧鞦蓮%張泓%王傳清%劉嵐%徐樨巍%馬耀玲%瀋敘莊
왕령%양영홍%륙권%왕예%진원%산력%산추련%장홍%왕전청%류람%서서외%마요령%침서장
肠球菌属%抗药性,多种,细菌%大环内酯类%药物监测%DNA可移植因子
腸毬菌屬%抗藥性,多種,細菌%大環內酯類%藥物鑑測%DNA可移植因子
장구균속%항약성,다충,세균%대배내지류%약물감측%DNA가이식인자
Enterococcus%Drug resistance,multiple,bacterial%Macrolides%Drug monitoring%DNA transposable elements
目的 研究儿科临床分离肠球菌的流行情况及红霉素耐药株基因ermB、mefA、tetM与转座子整合酶基因int-Tn分布特点.方法 采用KB纸片法对北京、上海、广州和重庆5家儿科专科医院2000-2006年临床分离粪、屎肠球菌进行8种抗菌药敏感性试验,并用琼脂稀释法测定225株红霉素耐药粪、屎肠球菌对大环内酯类及四环素最小抑菌浓度.PCR检测红霉素耐药基因ermB和mefA,四环素耐药基因tetM,以及转座子Tn1545的整合酶基因int-Tn.结果 4地5家儿童医院分离所得肠球菌对红霉素耐药率最高,平均耐药率86.5%;对氨苄西林、高浓度链霉素、高浓度庆大霉素、环丙沙星及利福平的耐药率分别为48.0%、47.6%、60.5%、45.4%、63.6%;未发现对万古霉素耐药的肠球菌.225株红霉素耐药粪、屎肠球菌ermB基因阳性率为70.7%,仅发现1株对mefA阳性的菌株.tetM基因阳性率为75.1%.Tn1545基因阳性株组ermB和tetM的携带率分别为84.8%和83.7%,高于阴性组60.9%和70.0%,且差异均有统计学意义(P均＜0.05).结论 我国儿科临床分离粪、屎肠球菌对多种抗菌药均有较高耐药率,对糖肽类抗菌药均保持较好敏感性,分离株对红霉素和四环素耐药主要机制分别是ermB编码的靶位改变和tetM编码的核糖体保护作用;接合性转座子Tn1545与tetM和ermB存在关系密切,可能是肠球菌多重耐药的重要机制之一.
目的 研究兒科臨床分離腸毬菌的流行情況及紅黴素耐藥株基因ermB、mefA、tetM與轉座子整閤酶基因int-Tn分佈特點.方法 採用KB紙片法對北京、上海、廣州和重慶5傢兒科專科醫院2000-2006年臨床分離糞、屎腸毬菌進行8種抗菌藥敏感性試驗,併用瓊脂稀釋法測定225株紅黴素耐藥糞、屎腸毬菌對大環內酯類及四環素最小抑菌濃度.PCR檢測紅黴素耐藥基因ermB和mefA,四環素耐藥基因tetM,以及轉座子Tn1545的整閤酶基因int-Tn.結果 4地5傢兒童醫院分離所得腸毬菌對紅黴素耐藥率最高,平均耐藥率86.5%;對氨芐西林、高濃度鏈黴素、高濃度慶大黴素、環丙沙星及利福平的耐藥率分彆為48.0%、47.6%、60.5%、45.4%、63.6%;未髮現對萬古黴素耐藥的腸毬菌.225株紅黴素耐藥糞、屎腸毬菌ermB基因暘性率為70.7%,僅髮現1株對mefA暘性的菌株.tetM基因暘性率為75.1%.Tn1545基因暘性株組ermB和tetM的攜帶率分彆為84.8%和83.7%,高于陰性組60.9%和70.0%,且差異均有統計學意義(P均＜0.05).結論 我國兒科臨床分離糞、屎腸毬菌對多種抗菌藥均有較高耐藥率,對糖肽類抗菌藥均保持較好敏感性,分離株對紅黴素和四環素耐藥主要機製分彆是ermB編碼的靶位改變和tetM編碼的覈糖體保護作用;接閤性轉座子Tn1545與tetM和ermB存在關繫密切,可能是腸毬菌多重耐藥的重要機製之一.
목적 연구인과림상분리장구균적류행정황급홍매소내약주기인ermB、mefA、tetM여전좌자정합매기인int-Tn분포특점.방법 채용KB지편법대북경、상해、엄주화중경5가인과전과의원2000-2006년림상분리분、시장구균진행8충항균약민감성시험,병용경지희석법측정225주홍매소내약분、시장구균대대배내지류급사배소최소억균농도.PCR검측홍매소내약기인ermB화mefA,사배소내약기인tetM,이급전좌자Tn1545적정합매기인int-Tn.결과 4지5가인동의원분리소득장구균대홍매소내약솔최고,평균내약솔86.5%;대안변서림、고농도련매소、고농도경대매소、배병사성급리복평적내약솔분별위48.0%、47.6%、60.5%、45.4%、63.6%;미발현대만고매소내약적장구균.225주홍매소내약분、시장구균ermB기인양성솔위70.7%,부발현1주대mefA양성적균주.tetM기인양성솔위75.1%.Tn1545기인양성주조ermB화tetM적휴대솔분별위84.8%화83.7%,고우음성조60.9%화70.0%,차차이균유통계학의의(P균＜0.05).결론 아국인과림상분리분、시장구균대다충항균약균유교고내약솔,대당태류항균약균보지교호민감성,분리주대홍매소화사배소내약주요궤제분별시ermB편마적파위개변화tetM편마적핵당체보호작용;접합성전좌자Tn1545여tetM화ermB존재관계밀절,가능시장구균다중내약적중요궤제지일.
Objective To determine the drug-resistance rate of Enterococci isolated from patients of 5 padiatric hospitals located at different areas in China,and to investigate the distribution of resistance genes ermB,mefA,tetM and the integrase gene intTn of Tn1545 in Enterococci.Methods The antimicrobial susceptibility to 8 antibiotics of 2 216 Enteroeocei isolates was determined.PCR was used to detect the macrolide resistance genes ermB and mefA,tetracycline resistance genes tetM,and the integrase gene int-Tn of Tn1545.Results The resistance rates to erythromycin,ampicillin,gentamicin and teicoplanin were 86.5%,48.0%,60.5% and 0.7%,respectively.All isolated Enterococci straim were found sensitive to vancomycin.Of the detected 225 strains,70.7% of the 225 detected strains carried ermB gene while 75.1% of them carried tetracycline resistance gene tetM:only one strain had mefA.The presence of ermB gene in erythromycin MIC＞256 mg/L straim group(95.7%)strains was higher than those in erythromycin MIC＜256 mg/L group(2.5%).The int-Tn gene was detected in 40.9%(92/225)of the 225 test strains.The presence of ermB gene in int-Tn positive group strains was higher(84.8%)than those in int-Tn negative strains group(60.9%).So did the tetM in int-Tn positive group(83.7%)compared with those in int-Tn negative group(70.0%).Conclusions Enterococci sbowed a high resistance rate to the antibiotics we monitored,especially to erythromycin;but still very senstive to glycopeptide antibiotics. Resistance to macrolide in Enterococci collected from clinical in five Children's Hospital was generally mediated by methylation of 23S rRNA via ermB methylase. Enterococci resistance to tetracycline was predominantly due to ribosomal protection encoded by tetM. There was a strong relationship of the ermB and tetM genes with Tn1545-related elements.
