肠球菌毒力因子研究进展

肠球菌(Enterococcus)是人和动物肠道的正常菌群,通常不引起发病,为一种重要的机会致病菌.最近几年,由于免疫制剂的广泛使用,侵入性治疗机会的增加和抗生素的过渡使用,尤其是第3代头孢菌素的广泛应用,使得肠球菌的感染不断上升,成为医院内感染的主要致病菌.肠球菌致病机制与其致病岛编码的毒力因子表面蛋白、溶血素、蛋白明胶酶等有关,肠球菌致病机理不是由单一毒力因子所决定,而是多种毒力因子共同作用的结果.文章综述了肠球菌的各种潜在毒力因子的生物特性及其与致病性的关系,为预防和控制肠球菌感染提供参考.     

粪肠球菌动物致病的研究进展

粪肠球菌又称粪链球菌,能在不同环境中生长存活,对外界环境抵抗力较强,部分属于动物肠道中的正常茵群,还有部分在长期的进化中出现了毒力基因。近年来,粪肠球菌感染人和动物的报道日益增加,逐渐得到人们的广泛关注。论文综述了猪、牛、羊、禽和犬粪肠球菌的主要致病性、毒力基因及耐药性,为防制动物粪肠球菌感染提供参考。     

肠球菌毒力因子的研究进展

肠球菌是人或动物肠道中的正常菌群。近年来在医学和兽医临床中肠球菌的感染已引起广泛关注。肠球菌除了具有特殊的耐药机制外,还拥有众多的毒力因子。本试验就目前已发现的肠球菌重要毒力因子作一综述。     

广东省养禽场肠球菌耐药性及毒力因子流行分布特征

旨在调查和分析广东省养禽场肠球菌的亚型屎肠球菌和粪肠球菌耐药性及其毒力因子流行分布特征,为控制禽源肠球菌耐药性传播、保障公共卫生安全提供理论依据。作者于2018年从广东省4个养禽场采集肠道样品493份,进行屎肠球菌和粪肠球菌的分离鉴定;采用琼脂二倍稀释法测定肠球菌的最小抑菌浓度（MIC）;PCR方法检测肠球菌的耐药基因和毒力基因。结果显示：1）共分离到125株肠球菌,其中粪肠球菌84株（鸡源66株,鸭源18株）;屎肠球菌41株,均来自鸡肠道样本。2）菌株对四环素、多西环素、红霉素几乎全部耐药,对氟苯尼考和氯霉素的耐药率高达89.60%和74.40%。屎肠球菌耐药率普遍高于粪肠球菌,而粪肠球菌对环丙沙星和利奈唑胺的耐药率高于屎肠球菌;鸭源粪肠球菌对利奈唑胺的耐药率（94%）显著高于鸡源粪肠球菌（39.4%）,屎肠球菌对利奈唑胺均敏感。从鸡分离的1株粪肠球菌对万古霉素耐药。3）耐药基因在屎肠球菌中的检出率高于粪肠球菌,鸭源分离株检出率高于鸡源。耐药基因tetL、fexA、ermB最为流行,检出率均高于90%。其次是optrA基因,检出率为73.60%,poxtA和fexB的检出率均低于20%。在3株鸭源粪肠球菌中检测出cfr基因。4）已检测的毒力基因中efaA的携带率最高,为63.04%（58/92）,其他依次为gelE（54.35%,50/92）、ace（47.83%,44/92）、asa1（44.57%,41/92）。对环丙沙星及高浓度氨基糖苷类耐药的菌株及携带cfr基因的菌株,大多携带agg、asal、gelE或ace。本研究显示养殖场禽源肠球菌耐药严重,鸭源肠球菌对利奈唑胺耐药率高,耐药基因和毒力基因流行且多样,且检测出人医临床重要抗生素耐药基因,应加强对养禽场肠球菌耐药性监测。     

鸭源肠球菌的致病性试验

以临床分离的2株鸭源肠球菌分别接种小白鼠,观察感染后小白鼠的主要临床症状和病变特点,并测定感染小白鼠的发病率、死亡率及半数致死量,旨在探讨这2个菌株对小白鼠的致病性。结果表明,2株肠球菌均能造成小白鼠发病。该病原主要侵害小白鼠肝脏、脾脏和肾脏,最明显的病变特征是引起脾肿大、纤维素性渗出性炎症;肝脏淤血、出血甚至坏死;肾间质血管淤血等。从而揭示了肠球菌可引起小鼠感染发病并导致组织病变而死亡。     

江西省猪源粪肠球菌毒力基因及耐药性分析

通过选择性培养基、PCR技术分离鉴定粪肠球菌,采用PCR技术检测agg、clyA、efaA、esp、ace和gelE基因,使用K-B法测定分离株对红霉素、多西环素、环丙沙星和氟苯尼考的敏感性。结果共分离并鉴定出226株粪肠球菌。98.23%的粪肠球菌至少携带1种毒力基因,各基因检出率由高到低依次为efaA、ace、gelE、agg、esp和clyA。有75.22%分离株携带3~5种毒力基因。分离株对红霉素和多西环素耐药率较高,分别为97.35%和92.48%,对环丙沙星和氟苯尼考耐药率相对较低,分别为65.04%和61.95%,但没有统计学上的区别。因此,携带毒力基因数的多少与抗菌药物的耐药性之间不存在统计学上的关联。     

猪源肠球菌明胶液化表型与5种毒力基因的检测分析

为探究明胶液化的表型与其5种毒力基因在不同来源和不同种属猪肠球菌中的分布差异,本研究采用PCR方法以及明胶液化试验对湖南分离的375株肠球菌携带的明胶酶基因(gelE)、调控gelE表达的毒力基因反应调节子基因(fsrA)、前肽加工蛋白基因(fsrB)、组氨酸激酶基因(fsrC)、丝氨酸蛋白酶基因(sprE)共5种毒力基因的分布情况以及液化明胶现象进行检测。结果显示,共263株肠球菌检测到了毒力基因,检出率分别为41.3%(gelE)、45.9%(fsrA)、50.9%(fsrB)、48.8%(fsrC)、48.8%(sprE)。能够同时检测到5种毒力基因的菌株共有110株,其中粪肠球菌106株,且该5种毒力基因在106株粪肠球菌中的检出率均为最高,另外4株为其它肠球菌。在明胶液化试验中,共有155株肠球菌检测到gelE基因,但只有106株能够发生明胶液化现象,且这些菌株正是能够同时检测到5种毒力基因的106株粪肠球菌,而另外4株能够同时检测到5种毒力基因的其它肠球菌却不能发生明胶液化现象。结果表明,粪肠球菌是肠球菌中主要携带毒力基因的菌属,与屎肠球菌以及其它肠球菌相比,更容易出现液化明胶的表型,这可能与粪肠球菌中某些明胶液化的机制有关,且除gelE外,参与gelE表达的几种毒力基因对该表型的出现也具有一定的影响。     

肠球菌主要毒力基因多重PCR方法的建立与应用

根据GenBank公布的基因序列,分别针对肠球菌属及其毒力基因cylA、esp和AS设计合成了4对引物。通过改进模板DNA提取方法和优化反应条件,建立了可以同时测定肠球菌和其携带的3种主要毒力基因的多重PCR方法。经过对不同来源的疑似肠球菌分离株进行检测,该多重PCR方法具有快速、可靠的特点。在不同来源的疑似肠球菌菌株中,临床感染分离株携带上述3种毒力基因的比例均高于鲜肉分离株和粪便分离株（分别为84．2％、55．7％和27．1％）;而且在各种来源肠球茵菌株中这3种毒力基因的携带率以cylA最高。     

牛源肠球菌的分离鉴定及毒力因子基因的检测

为探究牛源性肠球菌中6种毒力因子基因(ccf、asa1、ace、esp、cylA、gelE)的分布情况,采集了不同地区382份疑似隐形乳腺炎的奶样,常规分离纯化细菌,采用16SrRNA和16S~23SrRNA方法相结合的方法,共鉴定出了68株肠球菌并检测了其溶血特性和上述6种毒力基因的存在情况。结果显示,40株(58.82%)表现为α-溶血,10株(14.71%)为β-溶血,18株(26.47%)为γ-不溶血。68株(100%)携带asa1基因,49株(72.06%)携带gelE基因,43株(63.24%)携带ccf基因,12株(17.65%)携带ace基因,10株(14.71%)携带esp基因,6株(8.82%)携带cylA基因。54.41%的分离菌株同时携带gelE、ccf、asa1毒力基因,而青海民和分离株的esp与ace,gelE与ccf同时出现,有一定规律性;但溶血性基因cylA与14株溶血性肠球菌没有相关性。研究牛源肠球菌的溶血特性与毒力基因携带情况,对肠球菌性奶牛乳腺炎的防控具有指导意义,同时也为动物与人之间病原互相传播的研究提供试验依据。     

熊源粪肠球菌小鼠感染模型的建立及其毒力基因的检测

建立了熊源粪肠球菌(Enterococcus faecalis)感染BALB/c小鼠模型,并对熊源粪肠球菌的毒力基因进行检测,同时观察死亡小鼠内脏器官的组织病理学变化。结果:熊源粪肠球菌可以引起小鼠内脏组织发生不同程度的炎性细胞浸润,其对小鼠的LD_(50)为2.04×10~7 cfu/只;通过PCR可检测出胶原蛋白黏附素(ace)、心内膜炎抗原(efaA)、EF3314和明胶酶E(gelE)等毒力基因。研究表明,本试验成功建立了粪肠球菌小鼠感染模型,为熊源粪肠球菌的发病机制研究奠定了基础。     

一株羊源致病性屎肠球菌的分离鉴定及耐药性分析

试验从甘肃肃南县某羊场死亡羊中分离出疑似某球菌菌株XCP,为进一步确定该致病菌株及其耐药性情况,进行了病原菌分离、革兰氏染色、生化试验、16S rRNA PCR扩增鉴定、小鼠致病力试验、药敏试验、毒力基因和耐药基因扩增试验研究。结果发现,该菌革兰氏染色阳性,高盐、蜜二糖、蔗糖等生化反应阳性,VP、马尿酸盐、阿拉伯糖等生化反应阴性;16S rRNA基因PCR扩增后,进行BLAST比对,结果与GenBank中的屎肠球菌16S rRNA基因序列同源性为100%;小鼠致病力试验发现,该菌株具有很强的致病性;该菌株对β-内酰胺类抗生素苯唑西林、青霉素G,喹诺酮类抗生素诺氟沙星、环丙沙星、左氟沙星,以及四环素等高度耐药,对红霉素、万古霉素、克林霉素等抗生素敏感;毒力基因Asal、cylA、acm和耐药基因TetM、ant（6）-Ⅰ、aac（6'）-aph（2"）、ermB扩增均为阳性。结果表明,该菌为屎肠球菌（Enterococcus faecium）,具有较强的致病性和耐药性,可能与毒力基因和耐药基因的高阳性率有关。     

Isolation,Identification and Drug Resistance Analysis of Pathogenic Enterococcus feacium of Sheep

To further identify the pathogenic strains and analyze their antibiotic resistance, the methods of pathogen isolating, the methods of Gram staining, biochemical tests and 16S rRNA PCR amplification, virulence tests, drug sensitive tests, virulence genes and resistance genes PCR amplification were used. The results showed that the strain was Gram-positive and revealed positive after reacting with 6.5% NaCl, melibiose, sucrose and etc., while revealed negative reactions with VP, hippurate, arabinose and etc.. It showed 100% similarity with Enterococcus feacium 16S rRNA gene sequence in GenBank after PCR amplification of 16S rRNA gene and BLAST alignment. It was found severe pathogenicity after virulence tests in mice. The strain was highly resistant to oxacillin, penicillin G of β-lactam antibiotics and norfloxacin, ciprofloxacin, levofloxacin of quinolones antibiotics and tetracycline, while was sensitive to antibiotics of erythromycin, vancomycin and clindamycin. It revealed that virulence factor genes Asal, cylA, acm and resistance genes TetM, ant(6)-Ⅰ, aac(6')-aph (2"), ermB showed positive. The results showed that the bacteria was Enterococcus feacium, it had a strong pathogenicity and severe drug resistance, which might be related to the highly positive rates of virulence genes and drug resistance genes.     

J亚群禽白血病病毒与粪肠球菌混合感染的诊断及相关基因分析

为了解贵阳市某养殖场J亚群禽白血病病毒(Avian leukosis virus,ALV)gp85基因的变异情况及粪肠球菌(Enterococcus faecalis,EF)毒力基因的携带情况,本研究对该养殖场ALV与粪肠球菌混合感染的病例展开了病原学调查分析,采集病料进行病毒核酸检测、gp85基因克隆测序分析、核苷酸序列相似性分析、细菌分离鉴定、毒力基因检测等。结果显示,成功克隆出ALV gp85基因并分离鉴定出1株粪肠球菌,分别命名为GZM52021株和GZEF2021株。ALV核酸检测仅在约422 bp处出现特异性扩增条带,说明存在ALV-J感染;成功克隆ALV gp85基因,且GZM52021株与J亚群参考毒株gp85基因(GenBank登录号为KM655820、KF796654、JN378888和Z46390)的相似性较高,在97.9%~98.2%之间;gp85基因核苷酸序列遗传进化树构建结果与相似性结果一致。GZEF2021株在LB 固体平板上长出圆形凸起、不透明的乳白色菌落,在鲜血琼脂平板上有明显的溶血现象,革兰氏染色镜检为球形或卵圆形阳性链状球菌;16S rRNA测序结果显示,GZEF2021株与粪肠球菌(GenBank登录号为KJ626240、MT611693、KY399248、MH919370、MN379663和KU937389)的相似性均在99%以上;药敏试验结果显示,GZEF2021株对头孢哌酮、青霉素、哌拉西林和羧苄西林4种药物敏感,对复方新诺明、头孢拉定、头孢唑啉3种药物中度敏感,对新霉素、丁胺卡那、多西环素和米诺环素4种药物耐药;毒力基因检测显示,GZEF2021株携带有ace、gelE、asa1、EF3314和efaA 5个毒力基因,说明从鸡中分离出的粪肠球菌可能具有一定的致病性。该病死鸡存在J亚群ALV与粪肠球菌共同感染的情况,本试验结果可为了解J亚群ALV和粪肠球菌在贵州的流行趋势及其混合感染的诊治提供一定的参考资料。     

4株鸭源肠球菌的鉴定和致病性

对临床分离的4株鸭源肠球菌郑1株、郑2株、郑3株、北京株和1株粪肠球菌参考菌株进行了系统鉴定,并用SDS-PAGE和Western-blot技术对各菌株细胞壁蛋白图谱进行比较分析。结果5个菌株的形态、染色、生理生化特性均与粪肠球菌特性一致;它们均对青霉素、万古霉素和庆大霉素敏感而对四环素耐药;5个菌株人工感染雏鸭及小白鼠均有致病性,但各菌株间致病力存在差异,北京株最强,参考株最弱,其余3株介于北京株和参考株之间;各菌株的细胞壁蛋白经SDS-PAGE在相对分子质量33 370~131 690之间均显示数十条蛋白带,其中郑2株和北京株在相对分子质量66 840处均有1条染色较深的蛋白带,而用Western-blot分析显示抗北京株胞壁蛋白抗体只能检测到北京株相对分子质量为66 840的抗原蛋白。以上结果表明,这5个被检菌株为致病性粪肠球菌,且致病性以北京株最强。     

Enterococcus faecalis of human and poultry origin share virulence genes supporting the zoonotic potential of E. faecalis

Enterococcus faecalis is a major cause of nosocomial infections in humans and has been linked to severe extra‐intestinal infections in poultry. A zoonotic potential has been suggested and the aim of the present study was to investigate similarities in virulence gene profiles of E. faecalis originating from infections in humans and poultry respectively. A total of 106 isolates of E. faecalis [26 human clinical isolates, 60 poultry clinical isolates (including two small‐colony variants (SCVs) and 20 poultry cloacal isolates] were investigated for presence of seven virulence‐associated genes: ace, asa1, cylA, efaA, EF0591, esp and gelE. For each gene, the PCR‐amplification product was sequenced from one isolate in each group to explore intragenic variations between genes of human and poultry origin. Haemolytic and protease activities were assessed and isolates were assigned a sequence type (ST). Three of the seven genes investigated (ace, efaA and gelE) were present in all isolates. The asa1 was detected in 63/80 and 13/26 isolates of poultry and human origin respectively. For cylA, the numbers were 46/80 and 14/26 respectively. Among poultry isolates, esp and EF0591 were the least frequently observed genes (1/80 and 20/80 respectively); the prevalences among human isolates were 1/26 and 18/26 respectively. A high degree of similarity between genes in human and poultry isolates were confirmed by sequencing of amplification products. None of the cylA‐positive isolates demonstrated haemolytic activity, while the phenotypic expression of gelatinase varied. The ST16 was the only ST shared by human and poultry isolates. The SCV isolates did not show a unique virulence profile or phylogeny. In conclusion, regardless of the distinct phylogenetic background of most E. faecalis isolates of human and poultry origin, we found major similarities in virulence gene profile and gene sequences in isolates from the two sources, supporting the zoonotic risk associated with this organism.     

屎肠球菌及其微生态制剂的研究进展

屎肠球菌作为一种潜在的新型饲用抗生素替代品,具有耐热、耐胃酸、耐胆盐、粘附力强、抑菌性和抗生素耐受性等优良的生物学特性,还能提高饲料的转化效率,增强动物机体的免疫力,降低腹泻率及死亡率,从而改善动物产品品质,屎肠球菌微生态制剂在畜禽养殖业中应用已十分广泛。其中微囊化屎肠球菌活菌制剂更是近几年的研究热点,其抗逆性强、稳定性高,可以作为饲用高活性微生态制剂应用于实际生产。本文主要阐述屎肠球菌的生物学特性及其在饲用微生态制剂中的研究进展。     

屎肠球菌新序列型ST989菌株的分离鉴定及多重耐药性分析

试验从青海民和县某羊场致病性感染半月龄羔羊中分离出革兰氏阳性菌,感染羔羊临床症状有精神萎靡,采食减少,发病1~2 h后死亡。两只濒死羔羊剖检结果发现,其中一只出现肝脏肿大及肝包膜脱落,其余脏器无明显病理变化;另一只各脏器均未发现病理变化。分离病料,革兰氏染色发现,从病料中分离到的细菌均为革兰氏阳性球菌。对分离菌株进行Tuf基因PCR扩增,BLASTn比对结果显示与屎肠球菌AUS0085核苷酸序列相似性为99.8%,据此初步确定这些菌株为屎肠球菌。药敏试验结果表明,这些菌株可分为两类,第1类对β-内酰胺类、氨基糖苷类、大环内酯类、四环素类、喹诺酮类、利福霉素类抗生素及林可霉素和克林霉素耐药,对氯霉素和万古霉素敏感;第2类对β-内酰胺类、氨基糖苷类、四环素类、喹诺酮类、利福霉素类抗生素耐药,对红霉素和罗红霉素中度耐药,但对克拉霉素、阿奇霉素、克林霉素、林可霉素、氯霉素和万古霉素敏感。对第1类耐药性代表菌株lby1和第2类耐药性代表菌株lbg3进行多位点序列分析(MLST),结果发现这些菌株为一个屎肠球菌的新序列型,为ST989。系统进化树结果显示屎肠球菌lbg3与屎肠球菌ST468亲缘关系最近,致病力试验结果表明屎肠球菌lby1和lbg3均具有致病性。     

Isolation,Identification and Multidrug-resistant Analysis of the New Sequence Type ST989 Strain of Enterococcus faecium

Gram-positive cocci were isolated from half a month diseased lambs with a fatal infection in a sheep farm in Minhe county, Qinghai province.The clinical symptoms observed were drooping, reduced feed intake, emaciated and fever.The infected lambs died several hours after the disease been observed.Necropsy of two dying lambs revealed that for one lamb, the liver was enlarged and capsule of the liver dropped, and other organs had no obvious changes;For the other one, the organs had no obvious changes.After gram staining, gram-positive cocci were observed from all the samples.Partial Tuf gene sequences of these isolates were amplified and sequenced for species identification, BLASTn conparison result revealed that they had the highest sequence similarity with that of Enterococcus faecium (E.faecium) AUS0085 (99.8%), we thus primarily confirmed that these strains belonged to E.faecium.Antimicrobial susceptibility test indicated that these strains could be divided into two classes.Class 1 was resistant to β-lactams, aminoglycosides, macrolides, tetracyclines, quinolones, rifamycins, lincomycin and clindamycin;Susceptible to chloromycetin and vancomycin.Class 2 was resistant to β-lactams, aminoglycosides, tetracyclines, quinolones, rifamycins;Intermediate resistance to erythromycin and roxithromycin;But susceptible to clarithromycin, azithromycin, clindamycin, lincomycin, chloromycetin and vancomycin.Multilocus sequence typing (MLST) based on seven housekeeping genes for E.faecium revealed that E.faecium lby1 strain in class 1 and E.faecium lbg3 strain in class 2 were defined as a new sequence type ST989.Phylogenetic tree analysis revealed the representative strain of these isolates, E.faecium lbg3, was clustered together with E.faecium ST468.The pathogenicity test revealed that E.faecium lby1 and lbg3 strains both had pathogenicity.