肠球菌的耐药基因研究

目的了解肠球菌属的耐药性趋势和耐药基因分布，为临床合理用药提供依据。方法采用VITEK2COMPACT全自动微生物鉴定系统对2008年1月至2012年5月间临床送检标本中分离的319株肠球菌进行鉴定和药敏试验，采用PCR方法对ermB、mef、gyrA耐药基因进行研究。结果319株肠球菌中以屎肠球菌最多205株（64．26％），其次为粪肠球菌63株（19．75％），其他种类肠球菌51株（15．99％）。肠球菌常用抗生素药敏结果显示屎肠球菌和粪肠球菌耐药率最低的是万古霉素（1．0％．1．6％），其次是利茶唑胺和替考拉宁（3．9％，3．2％），耐药率最高的是红霉素（94．6％，79．4％）。肠球菌中ermB基因阳性率为73．4％（234／319），gyrA基因阳性率为67．1％（214／319），reef基因均为阴性。结论肠球菌获得gyrA基因和ermB基因是肠球菌对氟喹诺酮类药物和红霉素类药物耐药的主要原因。

The research of resistant gene of Enterococcus

Objective To understand the variation of clinical distribution and resistance gene of En- terococcus, and to provide the basis for the clinical rational medication. Methods 319 strains clinical Ente- rococcus were collected from January 2008 to May 2012. All strains were tested, and the drug resistant test were detected by VITEK2 COMPACT. The resistant genes of ermB, reef and gyrA were detected by PCR. Re- suits Among 319 strains Enterococcus, the most was Enterococcusfaceium 205 strains （64.26%）, the sec- ond was Enterococcus faeccdis 63 strains （ 19.75% ）, and the others were 51strains （ 15.99% ）. The lowest drug resistant rates of Enterococcus faceium and Enterococcus faecalis were vancomycin （ 1.0%, 1.6% ）, linezolid were （3.9%, 3.2%）. And the highest drug resistant rates were erythromycin （94.6%, 79.4% ）. The positive rates of ermB gene and gyrA gene were 73.4% （234/319） and 67.1% （214/319） respectively. And the reef gene all were negative. Conclusion Analysis showed that Enterococcus gain gyrA and ermB gene is the main reason of Enterococcus drug resistance to fluoroquinolones and erythromycin.