Novel Vancomycin-Resistance Transposon, Plasmid Replicon Types, and Virulence Factors of Vancomycin-Resistant Enterococci in Zhejiang, China
Novel Vancomycin-Resistance Transposon, Plasmid Replicon Types, and Virulence Factors of Vancomycin-Resistant Enterococci in Zhejiang, China
复制标题
DOI：
10.1089/mdr.2011.0140
复制
发表时间：
2012-04-01
影响因子：
2.6
通讯作者：
Yu, Yun-Song
中科院分区：
文献类型：
--
作者：
Qu, Ting-Ting;Yang, Qing;Yu, Yun-Song
从浙江省13家医院的临床标本和国内某大型教学医院ICU患者粪便标本中分离到47株万古霉素耐药肠球菌（VRE）。在健康人类受试者中未检测到VRE分离株。CC 17是屎肠球菌临床分离株的主要克隆复合物，但在健康人受试者的分离株中并非如此。在VRE菌株中检测到新的万古霉素抗性转座子。这是第一份证明Tn 1546的vanRS-vanH基因间区插入tnpA和fosB基因导致对万古霉素和磷霉素共耐药的报告。四种质粒复制子类型（普鲁姆、pRE 25、pEF 418和pB 82）在VRE分离株中更常见，表明它们与万古霉素耐药性和医院传播相关。万古霉素耐药金黄色葡萄球菌相关Inc 18样质粒pIP 501在VRE中的检出率为21.3%。esp基因在VRE分离株中的流行率较高（76.6%）。在一些VRE菌株中，esp和hyl基因通过接合与vanA基因共转移。虽然VRE在中国医院中的发生率较低，但其与毒力决定因子、万古霉素耐药转座子与其他耐药基因插入或质粒的相关性可能导致多药耐药和致病性VRE的进化。
Forty-seven vancomycin-resistant Enterococcus (VRE) strains were isolated from clinical samples in 13 Zhejiang hospitals and fecal samples from ICU patients in a large teaching hospital in China. No VRE isolates were detected in healthy human subjects. CC17 was the main clonal complex in clinical Enterococcus faecium isolates but not in isolates from healthy human subjects. Novel vancomycin-resistance transposons were detected among VRE strains. This is the first report demonstrating insertion of tnpA and fosB genes in the vanRS-vanH intergenic region of Tn1546 leading to coresistance to vancomycin and fosfomycin. The four plasmid replicon types (pRUM, pRE25, pEF418, and pB82) were more common in VRE isolates, suggesting their association with vancomycin resistance and nosocomial transmission. The prevalence rate of vancomycin-resistant Staphylococcus aureus-related Inc18-like plasmid, pIP501, in VRE was 21.3%. The prevalence of the esp gene among VRE isolates was high (76.6%). In several VRE strains, the esp and hyl genes were cotransferred with the vanA gene by conjugation. Although the frequency of VRE is low in Chinese hospitals, its association with virulence determinants, the vancomycin-resistance transposon with other resistance gene insertions or plasmids may lead to multidrug resistance and the evolution of pathogenic VRE.