Coombs Geoffrey W, Pearson Julie C, Christiansen Keryn, Gottlieb Thomas, Bell Jan M, George Narelle, Turnidge John D
Australian Collaborating Centre for Enterococcus and Staphylococcus Species (ACCESS) Typing and Research, School of Biomedical Sciences, Curtin University, Perth, Western Australia; Department of Microbiology and Infectious Diseases, PathWest Laboratory Medicine, WA, Royal Perth Hospital, Perth, Western Australia.
Department of Microbiology and Infectious Diseases, Concord, Concord, New South Wales.
Commun Dis Intell Q Rep. 2013 Sep 30;37(3):E199-209.
In 2010, 15 institutions around Australia conducted a period prevalence study of key resistances in isolates of Enterococcus species associated with a range of clinical disease amongst in- and outpatients. Each institution collected up to 100 consecutive isolates and tested these for susceptibility to commonly used antimicrobials using standardised methods. Vancomycin-resistant Enterococcus faecium and Enterococcus faecalis were characterised by pulsed-field gel electrophoresis. Multilocus sequence typing was performed on representative pulsotypes of E. faecium. Susceptibility results were compared with similar surveys conducted in 1995, 1999, 2003, 2005, 2007 and 2009. In the 2010 survey, E. faecalis (1,201 isolates) and E. faecium (170 isolates) made up 98.9% of the 1,386 isolates tested. Ampicillin resistance was very common (85.3%) in E. faecium and absent in E. faecalis. Non-susceptibility to vancomycin was 36.5% in E. faecium (similar to the 35.2% in 2009 but up from 15.4% in the 2007 survey) and 0.5% in E. faecalis. There were significant differences in the proportion of vancomycin-resistant E. faecium between the states ranging from 0% in Western Australia to 54.4% in South Australia. The vanB gene was detected in 62 E. faecium and 3 E. faecalis isolates. The vanA gene was detected in 1 E. faecium isolate. All vancomycin-resistant E. faecium belonged to clonal complex 17. The most common sequence type (ST) was ST203, which was found in all regions that had reports of vancomycin resistant enterococci. ST341 was detected only in New South Wales/Australian Capital Territory and ST414 only in South Australia and Victoria. High-level resistance to gentamicin was 34.1% in E. faecalis and 66.1% in E. faecium. A subset of isolates was tested against high-level streptomycin, linezolid and quinupristin/dalfopristin. High-level streptomycin resistance was found in 8.2% of E. faecalis isolates and 43.8% of E. faecium isolates. Linezolid non-susceptibility was more common in E. faecalis (5.8%) than E. faecium (0.9%). Overall 9.4% of E. faecium were resistant to quinupristin/dalfopristin (E. faecalis is intrinsically resistant).
2010年，澳大利亚各地的15家机构对门诊和住院患者中一系列临床疾病相关的肠球菌分离株的关键耐药性进行了期间患病率研究。每个机构收集了多达100株连续分离株，并使用标准化方法检测这些分离株对常用抗菌药物的敏感性。耐万古霉素屎肠球菌和粪肠球菌通过脉冲场凝胶电泳进行特征分析。对屎肠球菌的代表性脉冲型进行多位点序列分型。将敏感性结果与1995年、1999年、2003年、2005年、2007年和2009年进行的类似调查进行比较。在2010年的调查中，粪肠球菌（1201株分离株）和屎肠球菌（170株分离株）占所检测的1386株分离株的98.9%。氨苄西林耐药在屎肠球菌中非常常见（85.3%），而在粪肠球菌中不存在。屎肠球菌对万古霉素的不敏感性为36.5%（与2009年的35.2%相似，但高于2007年调查中的15.4%），粪肠球菌为0.5%。各州耐万古霉素屎肠球菌的比例存在显著差异，从西澳大利亚州的0%到南澳大利亚州的54.4%。在62株屎肠球菌和3株粪肠球菌分离株中检测到vanB基因。在1株屎肠球菌分离株中检测到vanA基因。所有耐万古霉素屎肠球菌均属于克隆复合体17。最常见的序列类型（ST）是ST203，在所有有耐万古霉素肠球菌报告的地区均有发现。ST341仅在新南威尔士州/澳大利亚首都直辖区检测到，ST414仅在南澳大利亚州和维多利亚州检测到。粪肠球菌对庆大霉素的高水平耐药率为34.1%，屎肠球菌为66.1%。对一部分分离株进行了针对高水平链霉素、利奈唑胺和奎奴普丁/达福普汀的检测。8.2%的粪肠球菌分离株和43.8%的屎肠球菌分离株发现有高水平链霉素耐药。利奈唑胺不敏感性在粪肠球菌（5.8%）中比屎肠球菌（0.9%）更常见。总体而言，9.4%的屎肠球菌对奎奴普丁/达福普汀耐药（粪肠球菌固有耐药）。
