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目的了解耐万古霉素屎肠球菌(VREFm)的基因存在状况,有利于临床治疗选药。方法依据2008年美国临床实验室标准化研究所推荐的纸片扩散法和琼脂稀释法,对VREFm进行药敏试验;PCR方法检测万古霉素和其他耐药基因的情况。结果万古霉素、替考拉宁、红霉素、青霉素G、四环素、利福平、克林霉素和高浓度庆大霉素均耐药,呋喃妥因、左氧氟沙星和利奈唑胺均为敏感,万古霉素MIC值为128μg/ml,基因表型为VanA,还检出TEM型β-内酰胺酶基因、ermB和mefA型红霉素耐药基因、aac(6′)-aph(2″)双功能酶编码基因和ant(6)-Ⅰ核苷酸转移酶编码基因。结论耐万古霉素屎肠球菌存在多种耐药基因。
Objective To understand the existence of vancomycin-resistant Enterococcus faecium (VREFm) gene and to facilitate the clinical treatment of drug selection. Methods According to the disk diffusion method and agar dilution method recommended by the American Society for Clinical Laboratory Standards in 2008, VREFm was tested for susceptibility and vancomycin and other drug resistance genes were detected by PCR. Results Vancomycin, teicoplanin, erythromycin, penicillin G, tetracycline, rifampicin, clindamycin and gentamicin at high concentrations were all resistant, nitrofurantoin, levofloxacin and linezolid were sensitive, eternal The MIC value was 128 μg / ml and the gene phenotype was VanA. The TEM - type β - lactamase gene, the ermB and mefA - type erythromycin resistance genes were also detected. AAC (6 ’) - aph Functional enzyme encoding gene and ant (6) -Ⅰ nucleotide transferase encoding gene.Conclusion Vancomycin-resistant Enterococcus faecium has multiple resistance genes.