Ray Amy J, Pultz Nicole J, Bhalla Anita, Aron David C, Donskey Curtis J
Department of Medicine, , University Hospitals of Cleveland, Ohio, USA.
Clin Infect Dis. 2003 Oct 1;37(7):875-81. doi: 10.1086/377451. Epub 2003 Sep 12.
The potential for transfer of vancomycin-resistance genes from enterococci to Staphylococcus aureus exists when these organisms share an ecologic niche. We performed an 8-month prospective study to determine the frequency at which S. aureus and vancomycin-resistant enterococci (VRE) coexist in the intestinal tracts of VRE-colonized patients and evaluated whether antianaerobic antibiotic therapy promoted increased density of S. aureus colonization. Of 37 patients colonized with vancomycin-resistant Enterococcus faecium, 23 (62%) had S. aureus recovered from stool specimens and 20 (87%) had methicillin-resistant strains. There was no significant difference in the mean density (+/- standard deviation) of S. aureus during versus > or =1 month after discontinuation of antianaerobic antibiotic therapy (5.1+/-1.5 vs. 4.7+/-1.6 log10 colony-forming units per gram of stool; P=.34). No S. aureus isolates were resistant to vancomycin. S. aureus and VRE often coexist in the intestinal tract, providing a potential reservoir for the emergence of vancomycin-resistant S. aureus isolates.
当肠球菌和金黄色葡萄球菌共享一个生态位时，存在万古霉素耐药基因从肠球菌转移至金黄色葡萄球菌的可能性。我们进行了一项为期8个月的前瞻性研究，以确定金黄色葡萄球菌和耐万古霉素肠球菌（VRE）在VRE定植患者肠道中共存的频率，并评估抗厌氧抗生素治疗是否会促使金黄色葡萄球菌定植密度增加。在37例耐万古霉素屎肠球菌定植患者中，23例（62%）粪便标本中培养出金黄色葡萄球菌，20例（87%）为耐甲氧西林菌株。抗厌氧抗生素治疗期间与停药后≥1个月时，金黄色葡萄球菌的平均密度（±标准差）无显著差异（每克粪便5.1±1.5对4.7±1.6 log10菌落形成单位；P = 0.34）。没有金黄色葡萄球菌分离株对万古霉素耐药。金黄色葡萄球菌和VRE常共存于肠道，为耐万古霉素金黄色葡萄球菌分离株的出现提供了一个潜在来源。
