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一种用于检测肠球菌中耐万古霉素基因的简单、快速且低成本的方法揭示了万古霉素可变株的暴发。

A Simple and Rapid Low-Cost Procedure for Detection of Vancomycin-Resistance Genes in Enterococci Reveals an Outbreak of Vancomycin-Variable .

作者信息

Abdullah Hozan Muhammed, Marbjerg Lis Høy, Andersen Lise, Hoegh Silje Vermedal, Kemp Michael

机构信息

Clinical Department, University of Southern Denmark, 5000 Odense, Denmark.

Department of Clinical Microbiology, Odense University Hospital, 5000 Odense, Denmark.

出版信息

Diagnostics (Basel). 2022 Aug 31;12(9):2120. doi: 10.3390/diagnostics12092120.

Abstract

The detection of resistance to vancomycin in enterococci cultured from patients is important for the treatment of individual patients and for the prevention of hospital transmission. Phenotypic antimicrobial resistance tests may fail to detect potential vancomycin-resistant enterococci. We have developed and tested a PCR based procedure for routine screening for vancomycin-resistance genes in clinical samples with enterococci. Primary cultures from diagnostic samples reported with growth of or were tested for and genes by real-time PCR without the isolation of specific bacteria. Up to ten samples were pooled and tested in each real-time PCR reaction, with subsequent individual testing of cultures from positive pools. In a one-month test period in 2017 gene was detected in one out of 340 urine samples with vancomycin-susceptible enterococci reported from diagnostic culture. A second test period in 2018 included 357 urine samples, and gene was detected in samples from eight patients. Subsequently, all urine samples reported with growth of during a period of one year were tested. Fifty-eight individuals were identified with enterococci, carrying the gene not previously detected. Routine molecular testing of primary culture material from patient samples may improve the detection of hospitalized patients carrying with resistance genes to vancomycin.

摘要

检测从患者身上培养出的肠球菌对万古霉素的耐药性,对于个体患者的治疗以及预防医院内传播都很重要。表型抗菌药物耐药性检测可能无法检测出潜在的万古霉素耐药肠球菌。我们开发并测试了一种基于聚合酶链反应(PCR)的程序,用于对含有肠球菌的临床样本进行万古霉素耐药基因的常规筛查。对于诊断样本中报告有或生长的初代培养物,通过实时PCR检测和基因,无需分离特定细菌。每个实时PCR反应中最多将十个样本合并进行检测,随后对阳性样本池中的培养物进行单独检测。在2017年为期一个月的测试期内,在诊断培养报告为对万古霉素敏感的肠球菌的340份尿液样本中,有一份检测到了基因。2018年的第二个测试期包括357份尿液样本,在八名患者的样本中检测到了基因。随后,对一年内报告有生长的所有尿液样本进行了检测。确定有58人感染了携带此前未检测到的基因的肠球菌。对患者样本的初代培养材料进行常规分子检测,可能会提高对携带万古霉素耐药基因的住院患者的检测率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c8a/9497569/55244e0470e5/diagnostics-12-02120-g001.jpg

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