Lu J J, Perng C L, Chiueh T S, Lee S Y, Chen C H, Chang F Y, Wang C C, Chi W M
Department of Pathology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan.
Epidemiol Infect. 2001 Jun;126(3):357-63. doi: 10.1017/s0950268801005453.
Ninety-three clinical isolates of vancomycin-resistant enterococci (VRE) collected from nine hospitals in Taiwan were examined for the presence of vanA, vanB, vanC1, or vanC2/vanC3 genes by a multiplex PCR. Forty-seven of these VRE isolates were vanA positive, 1 contained both vanC1 and vanA, 40 harboured vanB, 2 were vanC1, and 3 were identified to be vanC2/vanC3. Twenty-four vanA isolates were sensitive to teicoplanin and thus did not have a typical VanA phenotype. Five isolates with the VanC phenotype harboured vanB. None of the 40 clinically isolated vancomycin-susceptible E. faecium or E. faecalis and the vancomycin-resistant Leuconostoc and Pediococcus isolates were positive for any of the van genes. While performing nosocomial surveillance, VRE were isolated from 47 of 467 rectal swabs by culture. Compared with the conventional culture method, the sensitivity and specificity of the multiplex PCR for detecting and identifying vancomycin-resistance genes in enterococci directly from culture-positive broth were 97.9% and 100%, respectively. The results suggest that genotypic characterization of vancomycin-resistance is necessary for all clinical VRE isolates and that the multiplex PCR assay can be an alternative method for this purpose.
通过多重聚合酶链反应（PCR）对从台湾九家医院收集的93株耐万古霉素肠球菌（VRE）临床分离株检测vanA、vanB、vanC1或vanC2/vanC3基因的存在情况。这些VRE分离株中，47株vanA呈阳性，1株同时含有vanC1和vanA，40株含有vanB，2株为vanC1，3株鉴定为vanC2/vanC3。24株vanA分离株对替考拉宁敏感，因此不具有典型的VanA表型。5株具有VanC表型的分离株含有vanB。40株临床分离的万古霉素敏感粪肠球菌或屎肠球菌以及耐万古霉素的明串珠菌和片球菌分离株中，van基因均无阳性。在进行医院感染监测时，通过培养从467份直肠拭子中的47份分离出VRE。与传统培养方法相比，直接从培养阳性肉汤中检测和鉴定肠球菌中万古霉素耐药基因的多重PCR的灵敏度和特异性分别为97.9%和100%。结果表明，对所有临床VRE分离株进行万古霉素耐药基因分型鉴定是必要的，且多重PCR检测可作为实现此目的的替代方法。
