Department of Intensive Care Medicine, Chi-Mei Medical Center, Liouying, Tainan.
J Infect. 2010 Jul;61(1):34-43. doi: 10.1016/j.jinf.2010.04.007. Epub 2010 Apr 28.
Human infections due to non-faecalis and non-faecium Enterococcus species are emerging but data on the characteristics of these infections are limited.
We retrospectively reviewed the computerized database of the bacteriology laboratory at National Taiwan University Hospital from January 2000 through December 2008 to identify patients with non-faecalis and non-faecium enterococcal bacteremia.
Enterococcal bacteremia was diagnosed in 1887 patients during the study period and was caused by non-faecalis and non-faecium enterococci in 182 (9.6%) of these patients. The causative organisms included Enterococcus casseliflavus (n = 59, 3.1%), Enterococcus gallinarum (n = 58, 3.0%), Enterococcus avium (n = 45, 2.4%), Enterococcus hirae (n = 9, 0.5%), Enterococcus raffinosus (n = 9, 0.5%), Enterococcus durans (n = 2, 0.1%), Enterococcus cecorum (n = 2, 0.1%), and Enterococcus canintestini (n = 1, 0.5%). A commercially-available phenotypic identification system misidentified six isolates based upon sequence analysis of 16S and groESL genes. Among the 182 patients, 74 (40.7%) had catheter-associated bloodstream infection and 69 (37.9%) presented with biliary tract infection. Healthcare-associated enterococcal bacteremia comprised 99 (54.4%) episodes and a polymicrobial etiology was found in 106 (58.2%) episodes. The clinical manifestations varied between the infecting Enterococcus species. Multivariate logistic regression showed that immunocompromised status is the only risk factor for the all cause mortality.
Non-faecalis and non-faecium Enterococcus species can cause protean manifestations which vary with the infecting Enterococcus species. Misidentification of unusual enterococcal species might occur by the commercial identification methods and accurate identification with molecular methods is required.
非粪肠球菌和非屎肠球菌肠球菌引起的人类感染正在出现，但有关这些感染特征的数据有限。
我们回顾性地分析了台湾大学医院细菌学实验室的计算机数据库，该数据库的时间范围是从 2000 年 1 月至 2008 年 12 月，以确定患有非粪肠球菌和非屎肠球菌肠球菌菌血症的患者。
在研究期间，共诊断出 1887 例肠球菌菌血症患者，其中 182 例（9.6%）由非粪肠球菌和非屎肠球菌肠球菌引起。病原体包括鹑鸡肠球菌（59 株，3.1%）、鸡肠球菌（58 株，3.0%）、鸟肠球菌（45 株，2.4%）、海氏肠球菌（9 株，0.5%）、棉子糖肠球菌（9 株，0.5%）、坚韧肠球菌（2 株，0.1%）、盲肠肠球菌（2 株，0.1%）和猪肠球菌（1 株，0.5%）。一种市售的表型鉴定系统通过 16S 和 groESL 基因序列分析错误地鉴定了 6 株分离株。在 182 例患者中，74 例（40.7%）有导管相关血流感染，69 例（37.9%）有胆道感染。与医疗保健相关的肠球菌菌血症占 99 例（54.4%），106 例（58.2%）为混合微生物病因。不同感染肠球菌引起的临床表现也不同。多变量逻辑回归显示，免疫功能低下是所有原因死亡率的唯一危险因素。
非粪肠球菌和非屎肠球菌肠球菌可引起表现多样的感染，其临床表现因感染的肠球菌种类而异。商业鉴定方法可能会错误鉴定不常见的肠球菌种类，因此需要使用分子方法进行准确鉴定。
