肠球菌万古霉素耐药基因簇遗传特性.pdfVIP

Hereditas (Beijing) 2015 年5 月, 37(5): 452 ―457 综 述 肠球菌万古霉素耐药基因簇遗传特性 陈春辉，徐晓刚 复旦大学附属华山医院抗生素研究所，卫生部抗生素临床药理重点实验室，上海 200040 摘要:万古霉素耐药肠球菌自20 世纪80 年代后期被发现以来，已逐渐发展成为重要的医院感染病原菌。此类 耐药肠球菌携带的万古霉素耐药基因簇编码产物可催化合成与万古霉素、替考拉宁等糖肽类抗生素亲和力极低 的细胞壁前体导致耐药。目前已在肠球菌中发现的万古霉素耐药基因簇根据基因序列及构成不同分为9 个型别； 依据它们编码的连接酶合成产物不同又可分为 D-Ala:D-Lac 连接酶基因簇(VanA、VanB 、VanD 及 VanM 型)和 D-Ala:D-Ser 连接酶基因簇(VanC 、VanE 、VanG 、VanL 和VanN 型) 。这些耐药基因簇介导的耐药水平及其传播 模式各有特点。文章综述了肠球菌中万古霉素耐药基因簇的类型、基因构成及传播特性。 关键词:肠球菌属；万古霉素；耐药；基因簇 Genetic characteristics of vancomycin resistance gene cluster in Enterococcus spp Chunhui Chen, Xiaogang Xu Key Laboratory of Clinical Pharmacology of Antibiotics, Ministry of Health, Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai 200040, China Abstract: Vancomycin resistant enterococci has become an important nosocomial pathogen since it is discovered in late 1980s. The products, encoded by vancomycin resistant gene cluster in enterococci, catalyze the synthesis of peptidoglycan precursors with low affinity with glycopeptide antibiotics including vancomycin and teicoplanin and lead to resistance. These vancomycin resistant gene clusters are classified into nine types according to their gene se- quences and organization, or D-Ala:D-Lac (VanA, VanB, VanD and VanM) and D-Ala:D-Ser (VanC, VanE, VanG, VanL and VanN) ligase gene clusters based on the differences of their encoded ligases. Moreover, these gene clusters are characterized by their different resistance levels and infection models. In this review, we summarize the classifi- cation, gene organization and infection model of vancomycin resistant gene cluster in Enterococcus spp. Keywords: Enterococcus spp; vancomycin; resistance; gene cluster 肠球菌属(Enterococcus spp)是人类肠道以及泌 腹腔、伤口感染，以及血流感染和心内膜炎等严重 尿生殖道正常菌群，也可作为条件致病菌引起尿路、 感染[1] 。肠球菌属细菌中引起感染最多见的是粪肠 收稿日期: 2014−11−29 ; 修回日期: 2014−12−15