Nobile C G A, Ceravolo C, Rizzo L, Bianco A
Cattedra di Igiene, Facoltà di Medicina e Chirurgia, Università degli Studi di Catanzaro Magna Graecia, Italy.
Ann Ig. 2003 Sep-Oct;15(5):515-20.
The study evaluated prevalence of glycopeptide (vancomycin and teicoplanin) resistant enterococci (VRE) in hospitalized patients and in the community in Calabria (Italy). Rectal swabs were collected from hospitalized and community subjects. Information was gathered on demographics, ward and duration of hospital stay and antibiotics administered; in community subjects information on previous hospitalizations and antibiotics use in the previous year were also collected. Rectal swabs were plated on Enterococcosel agar alone and with addition of vancomycin (6 mg/l) and incubated aerobically at 37 degrees for 24-48 hours. Typical colonies were tested for Gram stain and catalase production. Enterococci were identified to the species level by biochemical tests. Antimicrobial susceptibility test and E-test were performed by the disk diffusion method to evaluate vancomycin and teicoplanin susceptibility. t-test and chi square test were performed to evaluate difference in means and proportions, respectively. Samples were collected from 211 subjects; 132 (62.6%) from community and 79 (37.4%) from hospitals. Enterococci were isolated from 145 subjects (68.7%), 72.7% and 62% in community and in hospital, respectively. The most frequent isolates were E. faecium (30.4%), followed by E. faecalis and E. durans (25.5%), and, finally, by Leuconostoc (18.6%). Only one E. faecium strain was resistant to both vancomycin and teicoplanin, isolated from a non-hospitalized 45 years old woman (1.3%). The results did not show emergence of VRE in our area, although surveillance to confirm these findings is needed, considering the substantial spread of antibiotics in hospitals and in the community.
该研究评估了意大利卡拉布里亚地区住院患者及社区中耐糖肽类(万古霉素和替考拉宁)肠球菌(VRE)的流行情况。从住院患者和社区人群中采集直肠拭子。收集了有关人口统计学、病房、住院时间及使用抗生素的信息;对于社区人群,还收集了上一年的既往住院史及抗生素使用情况。将直肠拭子分别接种于不含万古霉素及含6 mg/l万古霉素的肠球菌琼脂培养基上,于37℃需氧培养24 - 48小时。对典型菌落进行革兰氏染色及过氧化氢酶检测。通过生化试验将肠球菌鉴定到种水平。采用纸片扩散法进行抗菌药物敏感性试验及E试验,以评估万古霉素和替考拉宁的敏感性。分别采用t检验和卡方检验评估均值和比例的差异。共从211名受试者中采集样本,其中132名(62.6%)来自社区,79名(37.4%)来自医院。145名受试者(68.7%)分离出肠球菌,社区和医院的分离率分别为72.7%和62%。最常见的分离菌株为屎肠球菌(30.4%),其次是粪肠球菌和耐久肠球菌(25.5%),最后是明串珠菌(18.6%)。仅从一名45岁非住院女性中分离出一株对万古霉素和替考拉宁均耐药的屎肠球菌(1.3%)。尽管考虑到医院和社区中抗生素的大量使用,需要进行监测以证实这些发现,但我们地区的结果未显示VRE的出现。