Güdücüoğlu Hüseyin, Aktaş Elif, Beğendik Cömert Füsun, Aygül Kumru, Ozlü Nagihan, Baykal Sanem, Berktaş Mustafa, Ceylan Abdullah
Yüzüncü Yil Universitesi Tip Fakültesi, Mikrobiyoloji ve Klinik Mikrobiyoloji Anabilim Dali, Van.
Mikrobiyol Bul. 2009 Oct;43(4):535-43.
Upon isolation of the first vancomycin resistant enterococcus (VRE) from the urine sample of a nine months old patient in pediatric unit of Van Yuzuncu Yil University Hospital (located in eastern part of Turkey), we aimed to search for the presence of VRE isolates in the unit, to determine the resistance genotypes and to evaluate the clonal relationships among isolates. A total of 28 rectal swabs and 28 skin swabs from the patients, 12 skin swabs from the staff giving care to the patients, 15 skin swabs from the mothers of the patients and 96 environmental samples from the pediatric unit were screened. Antibiotic susceptibilities were tested and the resistance genotypes were determined. Molecular typing of the isolates was performed using pulsed-field gel electrophoresis (PFGE). Apart from the first case, 13 more VRE isolates, one being a clinical isolate from the urine of a patient and 12 isolates from the screening samples (8 rectal swabs, one skin swab and three swabs from patients' beds) were obtained. All of the isolates were identified as Enterococcus faecium with similar antibiotic susceptibility patterns. VanA gene was present in all of the isolates. PFGE demonstrated two major clones and five clones closely related with the major ones. This was the first VRE isolation and colonization reported in our region. The isolates belonged to more than one clone. Currently, VRE did not seem to be a significant pathogen in Turkey, however, there may be an underestimation of the problem and continuous surveillance studies should be undertaken in every region.
在从凡于祖尔居尔伊勒大学医院（位于土耳其东部）儿科病房一名9个月大患者的尿液样本中分离出首例耐万古霉素肠球菌（VRE）后，我们旨在探寻该病房中VRE分离株的存在情况，确定耐药基因型，并评估分离株之间的克隆关系。对来自患者的28份直肠拭子和28份皮肤拭子、照顾患者的医护人员的12份皮肤拭子、患者母亲的15份皮肤拭子以及儿科病房的96份环境样本进行了筛查。检测了抗生素敏感性并确定了耐药基因型。使用脉冲场凝胶电泳（PFGE）对分离株进行分子分型。除首例病例外，又获得了13株VRE分离株，其中1株是来自一名患者尿液的临床分离株，12株来自筛查样本（8份直肠拭子、1份皮肤拭子和3份患者病床拭子）。所有分离株均被鉴定为屎肠球菌，具有相似的抗生素敏感性模式。所有分离株均存在VanA基因。PFGE显示出两个主要克隆以及与主要克隆密切相关的五个克隆。这是我们地区首次报告VRE的分离和定植情况。分离株属于不止一个克隆。目前，VRE在土耳其似乎不是一种重要的病原体，然而，该问题可能被低估，每个地区都应进行持续的监测研究。
