Korean Journal of Clinical Laboratory Science (대한임상검사과학회지)

Korean Society for Clinical Laboratory Science (대한임상검사과학회)
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Detection of Vancomycin-Resistant Enterococci and Related Genes Using VITEK 2 System and Multiplex Real-time PCR Assay

VITEK 2 시스템과 Multiplex Real-time PCR을 이용한 반코마이신 내성 장알균(VRE)과 내성관련 유전자 검출

  • Jeong, Min-Kyung (Department of Laboratory Medicine, Chonnam National University Hospital) ;
  • Yu, Young-Bin (Department of Biomedical Laboratory Science, College of Medical Sciences, Konyang University) ;
  • Kim, Sang-Ha (Department of Laboratory Medicine, Konyang University Hospital) ;
  • Kim, Sunghyun (Department of Clinical Laboratory Science, College of Health Sciences, Catholic University of Pusan) ;
  • Kim, Young-Kwon (Department of Biomedical Laboratory Science, College of Medical Sciences, Konyang University)
  • 정민경 (전남대학교병원 진단검사의학과) ;
  • 유영빈 (건양대학교 의과학대학 임상병리학과) ;
  • 김상하 (건양대학교병원 진단검사의학과) ;
  • 김성현 (부산가톨릭대학교 보건과학대학 임상병리학과) ;
  • 김영권 (건양대학교 의과학대학 임상병리학과)
  • Received : 2017.11.03
  • Accepted : 2017.12.06
  • Published : 2017.12.31
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Abstract

In this study, using the VITEK 2 system, 74 samples (22.6%) out of 327 specimens were identified by the growth of Enterococcosel media (EV6 agar) supplemented with $6{\mu}g/mL$ of vancomycin. Enterococcus faecium was identified as 55 strains (74.3%), Enterococcus casseliflavus as 2 strains (2.7%), Enterococcus avium as 1 strain (1.4%), and Enterococcus gallinarum as 16 strains (21.6%). Among the 55 phenotypes of Enterococcus faecium, 42 (76.4%), 9 (16.4%), and 4 strains (7.3%) showed the vanA, vanB, and vanC phenotype, respectively. The 16 strains of Enterococcus gallinarum and 2 strains of Enterococcus casseliflavus showed the vanC phenotype and the 1 strain of Enterococcus avium had the vanB phenotype. The one strain of Enterococcus faecium propagated only in EV4 and was susceptible to both vancomycin and teicoplanin according to the antimicrobial susceptibility test using the VITEK 2 system. The vancomycin resistance phenotype gene was not detected by PCR. A total of 327 specimens were cultured in Enterococcosel broth supplemented with $6{\mu}g/mL$ of vancomycin (EV6 broth), and 120 strains (36.7%) were isolated. These 120 strains were subjected to vancomycin resistant genotyping by a multiplex real-time polymerase chain reaction and 51 strains (42.5%) showed vanA; 5 strains (4.2%) showed vanA and vanC; and 18 strains (15%) showed vanC. Vancomycin resistance genotypes were not detected in the remaining 46 strains (38.3%).

이 연구에서 VITEK 2 시스템을 사용하여 $6{\mu}g/mL$ vancomycin이 첨가된 Enterococcosel (EV6 agar에서 배양한 327개의 검체 중 74개의 분리균(22.6%)으로 확인하였다. E. faecium은 55주(74.3%), E. gallinarum 16주(21.6%), E. casseliflavus 2주(2.7%) 및 E. avium 1주(1.4%)로 확인되었다. E. faecium의 55가지 표현형 중 vanA가 42주(76.4%), vanB가 9주(16.4%), vanC 표현형이 4주(7.3%)로 나타났다. E. gallinarum 16주와 E. casseliflavus 2주 모두 vanC 표현형을 보였으며 E. avium 1주는 vanB 표현형을 나타내었다. EV4에서만 증식된 E. faecium 1주는 VITEK2 시스템을 이용한 항균제 감수성 검사 결과 vancomycin과 teicoplanin에 모두 감수성이었고 vancomycin 내성 표현형 유전자는 PCR에 의해 검출되지 않았다. 총 327 검체를 $6{\mu}g/mL$ vancomycin (EV6 broth)을 첨가 한 Enterococoscosel broth에서 배양하여 120 균주(36.7%)가 분리되었다. 120균주에서 다중 중합 효소 연쇄반응에 의한 반코마이신 내성 유전형 실험을 실시한 결과, vanA가 51주(42.5%), vanA와 vanC가 5주(4.2%), vanC가 18주(15%), 나머지 46주(38.3%)에서는 vancomycin 내성 유전형 유전자는 검출되지 않았다.

Keywords

References

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