伊朗医院中异质性万古霉素耐药粪肠球菌（VREfm）的高频分布。
High frequency distribution of heterogeneous vancomycin resistant Enterococcous faecium (VREfm) in Iranian hospitals.
机构信息
Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, P, O, Box: 14115-111, Tehran, Iran.
出版信息
Diagn Pathol. 2013 Oct 2;8:163. doi: 10.1186/1746-1596-8-163.
BACKGROUND
Enterococcus faecium is a multi-resistant nosocomial pathogen causing infection in debilitated patients. Vancomycin-resistant enterococcus faecium (VREfm) are a major concern and increased dramatically worldwide especially in hospitals environment. The current study focused on determining the high prevalence and distribution patterns of antibiotic resistance and also its genetic linkages among various VREfm strains isolated from indoor hospitalized patients in four major Iranian teaching hospitals of Tehran.
METHODS
The clinical samples were obtained from hospitalized patients during September 2010 to June 2011 from different teaching hospitals of Tehran. Antibiotics Resistance patterns, minimum inhibition concentration (MIC) value for vancomycin, ampicillin, gentamicin and presence of genetic linkage among the isolates were determined by pulsed-field gel electrophoresis (PFGE).
RESULTS
Overall, total of 92 (41.4%) isolates were identified as E. faecium, 45 (49%) were resistant to vancomycin with an MIC50 of ≥ 128 mg/L. The results showed that simultaneous resistance to teicoplanin, ampicillin, gentamicin, ciprofloxacine, tetracycline and erythromycin were observed the most frequent pattern. All the vancomycin resistant E. faecium isolates carried the vanA gene. intensive care units (ICUs) and Kidney transplantation, are most probably the wards with highest risk of infection by VRE. 17 pulsotypes were also detected by PFGE, most of the related pulsotypes belongs to the same hospitals.
CONCLUSIONS
This study shows the high alarming prevalence of Enterococcus faecium infection and similar clones of VREfm strains in Iranian hospitals with threatening resistance phenotypes.
VIRTUAL SLIDES
The virtual slides for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1270863903102282.
背景
屎肠球菌是一种多耐药的医院病原体，可导致虚弱患者感染。耐万古霉素肠球菌（VREfm）是一个主要关注点，在全球范围内，尤其是在医院环境中，其数量急剧增加。本研究集中于确定从德黑兰四家主要伊朗教学医院的住院患者室内分离的各种 VREfm 菌株的抗生素耐药性的高流行率和分布模式，以及其遗传联系。
方法
临床样本于 2010 年 9 月至 2011 年 6 月从德黑兰不同教学医院的住院患者中获得。通过脉冲场凝胶电泳（PFGE）测定抗生素耐药模式、万古霉素、氨苄西林、庆大霉素的最小抑菌浓度（MIC）值以及分离株之间的遗传联系。
结果
总共鉴定出 92 株（41.4%）屎肠球菌，其中 45 株（49%）对万古霉素耐药，MIC50≥128mg/L。结果表明，同时对替考拉宁、氨苄西林、庆大霉素、环丙沙星、四环素和红霉素耐药是最常见的模式。所有耐万古霉素的屎肠球菌分离株均携带 vanA 基因。重症监护病房（ICU）和肾移植病房可能是 VRE 感染风险最高的病房。PFGE 还检测到 17 个脉冲型，大多数相关的脉冲型都属于同一医院。
结论
本研究表明，伊朗医院屎肠球菌感染和相似的 VREfm 菌株克隆具有令人警惕的高流行率，存在威胁性的耐药表型。
Zotero 插件