Department of Laboratory Medicine, Ajou University School of Medicine, Suwon, Korea.
Ann Lab Med. 2012 Jan;32(1):82-6. doi: 10.3343/alm.2012.32.1.82. Epub 2011 Dec 20.
In July 2010, we identified an outbreak of vancomycin-resistant enterococci (VRE) in our 26-bed neonatal intensive care unit. We performed an epidemiological investigation after clinical cultures of 2 neonates were positive for VRE. Identification, susceptibility testing, and molecular characterization were performed. Cultures of 3 surveillance stool samples of inpatients and 5 environmental samples were positive for VRE. All isolates were identified as Enterococcus faecium containing the vanA gene. Two distinct clones were identified by performing pulsed-field gel electrophoresis. The 2 clones exhibited different pulsotypes, but they represented identical Tn1546 types. Two sequence types, ST18 and ST192, were identified among all of the isolates with multilocus sequence typing. Our investigation determined that the outbreak in the neonatal intensive care unit was caused by 2 genetically different clones. The outbreak may have occurred through clonal spread and horizontal transfer of the van gene.
2010 年 7 月，我们在 26 张床位的新生儿重症监护病房发现了万古霉素耐药肠球菌（VRE）的爆发。在 2 名新生儿的临床培养物呈 VRE 阳性后，我们进行了流行病学调查。进行了鉴定、药敏试验和分子特征分析。3 名住院患者的监测粪便样本和 5 个环境样本的培养物均呈 VRE 阳性。所有分离株均被鉴定为含有 vanA 基因的屎肠球菌。通过进行脉冲场凝胶电泳，确定了 2 个不同的克隆。这 2 个克隆表现出不同的脉冲模式，但它们代表了相同的 Tn1546 类型。对所有分离株进行多位点序列分型，确定了 2 种序列类型，ST18 和 ST192。我们的调查确定新生儿重症监护病房的爆发是由 2 个具有遗传差异的克隆引起的。爆发可能是通过克隆传播和 van 基因的水平转移引起的。
