National Medicines Institute, Warsaw, Poland.
J Antimicrob Chemother. 2012 Mar;67(3):551-8. doi: 10.1093/jac/dkr544. Epub 2011 Dec 29.
To investigate antimicrobial susceptibility and clonal relatedness of Enterococcus faecalis human isolates recovered recently (2006-09) in six European countries.
Antimicrobial susceptibility of 386 isolates from Denmark, Germany, Norway, Poland, Spain and The Netherlands, from hospital infections (223 isolates), carriage (82 isolates) and from colonization in the community (81 isolates) was determined by the broth microdilution method. Clonal relatedness of isolates was assessed by multilocus sequence typing.
All isolates were susceptible to benzylpenicillin, ampicillin, linezolid, tigecycline and daptomycin. Non-susceptibility to tetracycline (77.6%), rifampicin (57.3%), ciprofloxacin (51.2%), aminoglycosides (43.3% high-level gentamicin resistance, 40.0% high-level streptomycin resistance) was frequent among hospital isolates, while non-susceptibility to glycopeptides was rare and associated mostly with vanA. Multidrug resistance was found in 59.7% of hospital isolates and 16.1% of community isolates. Isolates were classified into 105 sequence types (STs), of which 21 STs, representing more than half of the collected isolates (53.9%), grouped with 6 large E. faecalis clonal complexes (CCs; CC2, CC16, CC21, CC30, CC40 and CC87). Two of these, CC2 (frequently recovered in Spain and The Netherlands) and CC87 (prevalent in Poland), were found almost exclusively in hospitals and included the highest proportion of multiresistant isolates.
While hospital-acquired E. faecalis in Europe remains susceptible to ampicillin and glycopeptides, the high prevalence of strains that are highly resistant to aminoglycosides excludes these antibiotics from combination therapies. Genotyping revealed that nosocomial infections by multiresistant E. faecalis are largely caused by only a few hospital-associated clones.
调查最近（2006-09 年）在六个欧洲国家从人类中分离的粪肠球菌对抗菌药物的敏感性和克隆相关性。
采用肉汤微量稀释法测定来自丹麦、德国、挪威、波兰、西班牙和荷兰的 386 株分离株（医院感染 223 株、定植 82 株和社区定植 81 株）的抗菌药物敏感性。通过多位点序列分型评估分离株的克隆相关性。
所有分离株均对青霉素、氨苄西林、利奈唑胺、替加环素和达托霉素敏感。医院分离株中，对四环素（77.6%）、利福平（57.3%）、环丙沙星（51.2%）和氨基糖苷类（高水平庆大霉素耐药 43.3%，高水平链霉素耐药 40.0%）的耐药性较为常见，而糖肽类药物的耐药性则很少见，主要与 vanA 相关。59.7%的医院分离株和 16.1%的社区分离株表现为多药耐药。分离株被分为 105 种序列型（ST），其中 21 种 ST 代表了一半以上的分离株（53.9%），与 6 个大的粪肠球菌克隆复合体（CC；CC2、CC16、CC21、CC30、CC40 和 CC87）有关。其中 2 个，即 CC2（在西班牙和荷兰经常分离到）和 CC87（在波兰流行），几乎仅在医院中发现，并且包含了比例最高的多耐药分离株。
尽管欧洲的医院获得性粪肠球菌对抗生素氨苄西林和糖肽类药物仍保持敏感性，但对氨基糖苷类药物高度耐药的菌株的高流行率排除了这些抗生素作为联合治疗的选择。基因分型表明，多耐药粪肠球菌引起的医院感染主要由少数医院相关克隆引起。
