魏影　郭妍　柏柳　陈艳丽　黄嵘赫　王德辉　余治健　陈俊文　钟婉莹　陈重　李桂秋

【摘要】 目的：分析新型四环素药物Eravacycline对我国屎肠球菌药物敏感性及分子分型特点。方法：收集深圳市南山区人民医院和哈尔滨医科大学附属第四医院屎肠球菌共235株。经BD phonixtm 100公司全自动药敏鉴定系统检测其常规药物药敏，琼脂稀释法测定Eravacycline药物敏感性，聚合酶链式反应（polymerase chain reaction，PCR）检测四环素抗性基因（tetM、tetL、tetU、tetK、tetS和tetO）。分析Eravacycline药敏与四环素耐药基因之间关系。结果：Eravacycline对屎肠球菌的MIC值≤0.5 μg/mL;

四环素耐药基因检测结果提示屎肠球菌tetM+tetL+tetU为18.30%（43/235），tetM+tetL为27.23%（64/235），所有含有四环素耐药基因的屎肠球菌的MIC≤0.5 μg/mL。结论：Eravacycline对我国屎肠球菌临床分离株具有较好的敏感性，四环素耐药基因对Eravacycline无影响。

【关键词】 屎肠球菌; 四环素耐药基因; Eravacycline; 抗感染药物敏感性

In Vitro Activity of Eravacycline and Characterisitics of Tetracycline Specific Resistance Genes in Enterococcus Faecium Clinical Isolates/WEI Ying，GUO Yan，BAI Liu，et al.//Medical Innovation of China，2019，16（18）：-110

【Abstract】 Objective：To investigate the antimcirobial susceptibility of Eravacycline and the distribution of Tetracycline specific resistance genes in Enterococcus faecium clinical isolates.Method：A total of 235 strains of Enterococcus faecium were collected from Shenzhen Nanshan Peoples Hospital and the Fourth Affiliated Hospital of Harbin Medical University from 2011 to 2016.The antimicrobial susceptibility of the commonly used antbiotics on Enterococcus faecium clinical isolates were determined by the automatic drug sensitivity identification system（BD phonixtm 100），the minimal inhibitory concentration（MIC）of Eravaycline was measured by agar dilution method，polymerase chain reaction（PCR）was carried out to detect the presence of tetracycline specific resistance genes，including tetM，tetL，tetU，tetK，tetS and tetO.Result：Eravacycline exhibitted the good in vitro activity against Enterococcus faecium clinical isolates with the MIC as low as ≤0.5 μg/mL.The presence of tetM+tetL+tetU and tetM+tetL were the most common combination of the Tetracycline resistance genes，indicating the frequency were 18.3%（43/235）and 27.23%（64/235）respectively.Conclusion：The clinical isolates of Enterococcus faecium in China are susceptible to Tetracycline，but the resistance gene on Tetracycline has no effect on Eravacycline.

【Key words】 Enterococcus faecium; Tetracycline specific resistance genes; Eravacycline; Antimicrobial susceptibility

First-authors address：Heilongjiang Medical Service Management Evaluation Center，Harbin 150036，China

doi：10.3969/j.issn.1674-4985.2019.18.028

根據2015年中国细菌耐药监测网显示屎肠球菌感染在革兰阳性菌感染排在第五位。该类细菌对低浓度氨基糖苷类、头孢菌素、克林霉素等呈现天然耐药表型，近年来屎肠球菌对万古霉素、替考拉宁和利奈唑胺等主要治疗药物耐药报道逐渐增多，全世界多个地区已经出现了耐万古霉素肠球菌株广泛流行，这些耐药株的出现和传播使屎肠球菌所致重症感染治疗已成为临床棘手的问题之一[1-2]。因此不断发现对屎肠球菌感染治疗有效药物是目前紧迫的问题之一。

既往文献已证实新型四环素药物替加环素是治疗屎肠球菌感染的新型药物选择之一[3]。近年刚获FDA批准的Eravacycline是新型的四环素……