健康人群肠道中<i>optrA</i>阳性肠球菌的流行率及风险因素

项秋梅; 吕子全; 沈应博; 汪洋; 沈建忠; 吴思英; 柯跃斌

doi:10.16462/j.cnki.zhjbkz.2022.11.012

健康人群肠道中optrA阳性肠球菌的流行率及风险因素

doi: 10.16462/j.cnki.zhjbkz.2022.11.012

项秋梅^{1, 2},
吕子全²,
沈应博^{3, 4},
汪洋⁴,
沈建忠⁴,
吴思英^1, ,,
柯跃斌^2, ,

1.
350122 福州, 福建医科大学公共卫生学院
2.
518073 深圳, 深圳市疾病预防控制中心分子流行病学研究室
3.
100101 北京, 中国科学院微生物研究所病原微生物与免疫学重点实验室
4.
100193 北京, 中国农业大学动物医学院

基金项目:

国家重点研发计划 2018YFD0500303

深圳市医学重点学科 SZXK066

食源性病原菌耐药性产生和传播机制及人类健康风险研究 JCYJ20170413101841798

详细信息

通讯作者:
柯跃斌, E-mail: keyke@szu.edu.cn

吴思英, E-mail: fmuwsy@163.com

中图分类号: R181
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- PDF下载量: 24
- 被引次数: 0
出版历程
- 收稿日期: 2021-08-24
- 修回日期: 2022-01-26
- 网络出版日期: 2022-12-21
- 刊出日期: 2022-11-10

Prevalence and risk factors of optrA-positive Enterococcus in healthy human gut

XIANG Qiu-mei^{1, 2},
LYU Zi-quan²,
SHEN Ying-bo^{3, 4},
WANG Yang⁴,
SHEN Jian-zhong⁴,
WU Si-ying^{1
, ,},
KE Yue-bin^{2
, ,}

1.
School of Public Health, Fujian Medical University, Fuzhou 350122, China
2.
Key Laboratory of Molecular Epidemiology, Shenzhen Center for Disease Control and Prevention, Shenzhen 510873, China
3.
CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China
4.
College of Veterinary Medicine, China Agricultural University, Beijing 100193, China

Funds:

National Key R&D Program of China 2018YFD0500303

Shenzhen Key Medical Discipline SZXK066

Research on the Produce and Transmission Mechanism of Foodborne Pathogens's Drug Resistance and the Influence of Human Health Risk JCYJ20170413101841798

More Information

Corresponding author: WU Si-ying, E-mail: fmuwsy@163.com; KE Yue-bin, E-mail: keyke@szu.edu.cn

摘要

摘要: 目的研究深圳市健康人群肠道携带optrA阳性肠球菌流行率及其风险因素。方法共调取2018—2019年社区健康体检者粪便样本565份，采用肠球菌选择培养基筛选耐氟苯尼考肠球菌，使用MALDI-TOF MS(MALDI Biotyper, Bruker, Germany)进行种属鉴定及PCR鉴定optrA基因。以optrA阳性肠球菌的携带者作为病例，以年龄为匹配条件，按1∶4匹配未携带者作为对照。采用多因素logistic回归分析模型分析optrA阳性肠球菌定植于健康人群肠道的风险因素。结果 2018—2019年深圳市健康人群肠道中optrA基因的流行率为18.10%(102/565，95% CI: 14.90%~21.20%)，从基因阳性人群粪便中共分离447株optrA阳性肠球菌，粪肠球菌为最主要流行种属(76.06%)。猪肉日摄入量＞50.0 g (OR=1.615，95% CI: 1.017~2.565，P=0.042)、3个月内住院治疗(OR=11.551，95% CI: 2.153~61.963，P=0.004)是optrA阳性肠球菌在健康人群肠道中定植的危险因素。结论 optrA阳性肠球菌在深圳市健康人群肠道中已广泛流行，其可能通过食物链传播至人类，同时住院治疗将增加optrA阳性肠球菌在健康人群肠道中定植的风险。
- 利奈唑胺 /
- 肠球菌 /
- optrA /
- 流行率 /
- 危险因素
Abstract: Objective To investigate the prevalence and risk factors of optrA-positive Enterococcus in the healthy people in Shenzhen City. Methods A total of 565 feces of the healthy pepople during 2018-2019 was cultured on enterococcal-selective plates to obtain florfenicol-resistant Enterococcus. MALDI Biotyper, Bruker, Germany (MALDI-TOF MS) was used for the species identification and PCR was used for optrA gene confirmation. People carrying optrA-positive enterococci were defined as positive cases and four times people with optrA-negative were randomly selected as control cases using the age of matching condition. A multivariate logistic regression model was used to analyze the risk factors of optrA-positive Enterococcus colonization in the human intestines. Results Overall, the prevalence of optrA-positive individuals was 18.10% (102/565, 95% CI: 14.90%-21.20%) in Shenzhen during 2018-2019. A total of 447 optrA-enterococci strains was isolated from the above samples, of which the Enterococcus faecalis was the most prevalent species (76.06%). Pork intake >50 g/d (OR=1.615, 95% CI: 1.017-2.565, P=0.042) and hospitalization within 3 months (OR=11.551, 95% CI: 2.153-61.963, P=0.004) were risk factors for optrA-positive Enterococcus colonization in the healthy human intestines. Conclusions optrA-positive Enterococcus have been already widespread in the human intestines in Shenzhen, and these bacteria may spread to humans through the food chain. Meanwhile, hospitalization will increase the risk of optrA-positive Enterococcus colonizing in the healthy hunman intestines.
- Linezolid /
- Enterococcus /
- optrA /
- Prevalence /
- Risk factors

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图 1 optrA阳性肠球菌菌种分布

Figure 1. Distribution of optrA-positive Enterococcus species

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表 1 研究人群一般情况[n(%)]

Table 1. General situation of the study population [n(%)]

变量	optrA阳性肠球菌定植病例组		χ²/U值	P值	变量	optrA阳性肠球菌定植病例组		χ²/U值	P值
变量	有(n=102)	无(n=408)	χ²/U值	P值	变量	有(n=102)	无(n=408)	χ²/U值	P值
性别			0.009	0.926	饮料			3.345	0.067
男性	36(35.3)	146(35.8)			无或极少	89(87.3)	376(92.8)
女性	66(64.7)	262(64.2)			每周1次以上	13(12.7)	29(7.2)
年龄[M (P₂₅，P₇₅), 岁]	56(46, 64)	59(50, 64)	-1.740	0.082	宠物			0.153	0.695
高血压			0.893	0.345	无	96(94.1)	386(95.1)
无	82(80.4)	310(76.0)			有	6(5.9)	20(4.9)
有	20(19.6)	98(24.0)			饮用水烧开			0.400	0.527 ^b
高血脂			0.084	0.772	无	4(3.9)	9(2.2)
无	85(83.3)	335(82.1)			有	98(96.1)	399(97.8)
有	17(16.7)	73(17.9)			饮食种类			0.32	0.866 ^a
糖尿病			0.129	0.661	非素食者	78(76.5)	316(77.5)
无	96(94.1)	379(92.9)			素食者	24(23.5)	90(22.5)
有	6(5.9)	29(7.1)			参加锻炼			0.455	0.5
胃肠道疾病			1.618	0.203	无	22(21.6)	76(18.6)
有	90(88.2)	339(83.1)			有	80(78.4)	332(81.4)
无	12(11.8)	69(16.9)			医疗接触史(3个月内) ^c			6.572	0.01
吸烟史			3.812	0.149	无	92(90.2)	393(96.3)
无	87(85.3)	325(79.7)			有	10(9.8)	15(3.7)
有	4(3.9)	41(10.0)			住院治疗(3个月内) ^c			8.700	0.003 ^b
已戒烟	11(10.8)	142(10.3)			无	97(95.1)	406(99.5)
饮酒史			0.872	0.647 ^b	有	5(4.9)	2(0.5)
无	82(80.4)	330(80.9)			抗生素(3个月)			1.106	0.293
有	17(16.7)	59(14.5)			无	94(92.2)	387(94.9)
已戒酒	3(2.9)	19(4.6)			有	8(7.8)	21(5.1)
注：^a连续性校正；^b Fisher确切概率法计算所得值；^cP < 0.05。

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表 2 研究人群的食物日摄入量的比较[n(%)]

Table 2. Comparison of the daily food intake of the study population [n(%)]

变量(g)	M(P₂₅, P₇₅)	optrA阳性肠球菌定植		χ²/U值	P值	变量(g)	M (P₂₅, P₇₅)	optrA阳性肠球菌定植		χ²/U值	P值
变量(g)	M(P₂₅, P₇₅)	有(n=102)	无(n=408)	χ²/U值	P值	变量(g)	M (P₂₅, P₇₅)	有(n=102)	无(n=408)	χ²/U值	P值
大米	250.0(121.3, 500.0)			0.200	0.655	鸭肉	7.1(0.0, 21.4)			0.002	0.965
≤250.0		60(58.8)	230(56.4)			≤7.1		49(48.0)	195(47.8)
>250.0		42(41.2)	178(43.6)			>7.1		53(52.0)	213(52.2)
面粉	50.0(11.5, 100.0)			0.128	0.720	淡水鱼^a	21.4(7.1, 42.7)			4.521	0.033
≤50.0		60(58.8)	232(56.9)			≤21.4		62(60.8)	200(49.0)
>50.0		42(41.2)	176(43.1)			>21.4		40(39.2)	208(51.0)
杂粮	6.9(1.1, 14.2)			0.110	0.740	海鲜	4.9(0.1, 14.3)			1.666	0.640
≤6.9		14(13.7)	51(12.5)			≤4.9		55(53.9)	196(48.0)
>6.9		88(86.3)	357(87.5)			>4.9		47(46.1)	212(52.0)
猪肉	50.0(21.4, 100.0)			2.846	0.092	奶制品	71.2(3.6, 249.8)			0.099	0.752
≤50.0		47(46.1)	226(55.4)			≤71.2		43(42.2)	165(40.4)
>50.0		55(53.9)	182(44.6)			>71.2		59(57.8)	243(59.6)
牛肉	6.9(1.1, 14.3)			0.196	0.658	鸡蛋	50.0(21.4, 50.0)			0.099	0.752
≤6.9		53(52.0)	202(49.5)			≤50.0		92(90.2)	382(93.6)
>6.9		49(48.0)	206(50.5)			>50.0		10(9.8)	26(6.4)
羊肉	0.4(0.0, 3.3)			0.237	0.626	蔬菜	150.0(200.0, 300.0)
≤0.4		49(48.0)	207(50.7)			≤200.0		57(55.9)	217(53.2)
>0.4		53(52.0)	201(49.3)			>200.0		45(44.1)	191(46.8)
鸡肉	8.2(3.3, 28.5)			0.002	0.965	油类	30.0(48.2, 68.9)			1.225	0.268
≤8.2		51(50.0)	205(50.2)			≤48.2		56(54.9)	199(48.8)
>8.2		51(50.0)	203(49.8)			>48.2		46(45.1)	209(51.2)
注：^aP < 0.05。

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表 3 多因素logistic回归分析

Table 3. Multivariate logistic regression analysis

风险因素	分类	模型1		模型2
风险因素	分类	OR (95% CI)值	P值	OR (95% CI)值	P值
淡水鱼日摄入量(g)	>21.4	0.571(0.359~0.907)	0.018	0.527(0.327~0.850)	0.009
猪肉日摄入量(g)	>50.0	1.744(1.107~2.749)	0.016	1.615(1.017~2.565)	0.042
住院治疗(3个月内)	有	11.357(2.139~60.303)	0.004	11.551(2.153~61.963)	0.004
饮料摄入	每周1次以上	2.335(1.140~4.784)	0.020	2.335(0.954~4.784)	0.066
注：模型1：纳入淡水鱼、猪肉摄入量、住院治疗及饮料摄入；模型2:纳入淡水鱼、猪肉摄入量、住院治疗及饮料摄入，并调整性别、年龄。

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