从伊朗教育医院分离出的耐万古霉素屎肠球菌和粪肠球菌。
Vancomycin-resistant enteroccus faecium and enterococcus faecalis isolated from education hospital of iran.
作者信息
Kafil Hossein Samadi, Asgharzadeh Mohammad
机构信息
Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Infectious Disease and Tropical Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
出版信息
Maedica (Bucur). 2014 Dec;9(4):323-7.
INTRODUCTION
Enterococci are opportunistic pathogens which represent one of the leading agents of nosocomial infections, especially urinary tract infections (UTI) in hospitalized patients. The aim of the present study was to determine the resistance pattern and the type of resistance genes in vancomycin-resistant Enterococcus isolated from an educational hospital in Iran.
MATERIALS AND METHODS
From February 2012 till February 2013, one hundred and eighty six clinical isolates from different department of educational hospitals were collected and identified as Enterococci and specified by biochemical tests. Identification was confirmed by specific PCR. Antibiotic resistance properties of strains were examined by Kerby-bauer method. PCR was performed for ddlE, ddlF, vanA and vanB genes.
RESULTS
One hundred and six (57%) isolates were identified as E. faecalis and 80 (43%) of the isolates were identified as E. faecium. 24 isolates had vanA gene and 19 isolates had vanB genes. In E. faecalis isolates, 15 isolates had vanB and 4 isolates had vanA gene. In E. faecium isolates, 20 isolates had vanA and 4 isolates had vanB gene. Prevalence of van genes between E. faecalis and E. faecium were significantly different for both vanA and vanB (p<0.01, p<0.041, respectively). VRE isolates were sensitive to Linezolid, Nitrofurantoin and Tigecyclin.
DISCUSSION
The overall prevalence of VRE was 23.65%, which shows an increase in VRE isolation in our region. Also, prevalence of E. faecium dramatically increased from 9% to 43% in the present study. Also increase in Gentamicin resistant isolates observed, but VRE isolates were sensitive to Linezolid, Tigecyclin and Nitrofurantoin. Stewardships for antibiotic usage in hospitals, especially for last option antibiotics, can prevent the spread of resistant isolates and losing all treatment options in the future.
引言
肠球菌是机会致病菌，是医院感染的主要病原体之一，尤其是住院患者的尿路感染（UTI）。本研究的目的是确定从伊朗一家教学医院分离出的耐万古霉素肠球菌的耐药模式和耐药基因类型。
材料与方法
2012年2月至2013年2月，从教学医院不同科室收集了186株临床分离株，经鉴定为肠球菌，并通过生化试验进行了分类。通过特异性PCR进行了确认。采用 Kirby-bauer 方法检测菌株的抗生素耐药特性。对 ddlE、ddlF、vanA 和 vanB 基因进行了PCR检测。
结果
106株（57%）分离株被鉴定为粪肠球菌，80株（43%）分离株被鉴定为屎肠球菌。24株分离株携带 vanA 基因，19株分离株携带 vanB 基因。在粪肠球菌分离株中，15株携带 vanB 基因，4株携带 vanA 基因。在屎肠球菌分离株中，20株携带 vanA 基因，4株携带 vanB 基因。粪肠球菌和屎肠球菌中 van 基因的流行率在 vanA 和 vanB 方面均有显著差异（分别为 p<0.01，p<0.041）。耐万古霉素肠球菌分离株对利奈唑胺、呋喃妥因和替加环素敏感。
讨论
耐万古霉素肠球菌的总体流行率为23.65%，这表明我们地区耐万古霉素肠球菌的分离率有所增加。此外，在本研究中，屎肠球菌的流行率从9%急剧增加到43%。同时观察到庆大霉素耐药分离株增加，但耐万古霉素肠球菌分离株对利奈唑胺、替加环素和呋喃妥因敏感。医院抗生素使用管理，特别是对最后一线抗生素的管理，可以防止耐药分离株的传播以及未来失去所有治疗选择。
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