Suh Jin Woong, Ju Yongguk, Lee Chang Kyu, Sohn Jang Wook, Kim Min Ja, Yoon Young Kyung
Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea,
Institute of Emerging Infectious Diseases, Korea University College of Medicine, Seoul, Republic of Korea,
Infect Drug Resist. 2019 Jan 4;12:161-171. doi: 10.2147/IDR.S184518. eCollection 2019.
This study investigated the clinical epidemiology, antimicrobial susceptibility, and molecular epidemiology of isolates.
An observational study was conducted at a university hospital in the Republic of Korea from August to December 2016. All subjects were patients who tested positive for clinically. Clinical data were analyzed to evaluate the microbiological and genotypic characteristics of strains.
Sixty-seven isolates recovered from non-duplicated patients were characterized. Patients were classified into three groups according to the infection type: nosocomial infection (71.6%), health care-associated infection (8.7%), and community-acquired infection (18.8%). The most common clinical specimens were urine (35.8%) and skin abscesses (32.8%). Fifty-two (77.6%) isolates showed multidrug resistance, defined as resistance to ≥3 different antibiotic families. All strains were susceptible to vancomycin and linezolid. Resistance to other antibiotics varied: penicillin (n=65; 97.0%), ampicillin (n=63; 94.0%), cefotaxime (n=64; 95.5%), and levofloxacin (n=61; 91.0%). Phylogenetic analysis identified all 16 S rRNA gene sequences of the 67 isolates as those of where 98%-99% were homologous to ATCC 6940. In multilocus sequence typing for internal transcribed spacer region, , and sequencing, the most predominant sequence types (STs) were ST2, ST3, ST6, and ST5.
isolates may cause opportunistic infections associated with nosocomial infections through horizontal transmission. The presence of multidrug resistance and intra-hospital dissemination implicate isolates as a potential target pathogen for infection control and antimicrobial stewardship programs.
本研究调查了分离株的临床流行病学、抗菌药物敏感性及分子流行病学。
2016年8月至12月在韩国一家大学医院进行了一项观察性研究。所有受试者均为临床检测呈阳性的患者。对临床数据进行分析，以评估菌株的微生物学和基因型特征。
对从非重复患者中分离出的67株菌株进行了特征分析。根据感染类型将患者分为三组：医院感染（71.6%）、医疗保健相关感染（8.7%）和社区获得性感染（18.8%）。最常见的临床标本是尿液（35.8%）和皮肤脓肿（32.8%）。52株（77.6%）分离株表现出多重耐药性，定义为对≥3个不同抗生素家族耐药。所有菌株对万古霉素和利奈唑胺敏感。对其他抗生素的耐药性各不相同：青霉素（n = 65；97.0%）、氨苄西林（n = 63；94.0%）、头孢噻肟（n = 64；95.5%）和左氧氟沙星（n = 61；91.0%）。系统发育分析确定67株分离株的所有16S rRNA基因序列均为某菌属的序列，其中98%-99%与某菌属ATCC 6940同源。在内部转录间隔区、某基因和某基因测序的多位点序列分型中，最主要的序列类型（STs）是ST2、ST3、ST6和ST5。
某菌属分离株可能通过水平传播引起与医院感染相关的机会性感染。多重耐药性的存在和医院内传播表明某菌属分离株是感染控制和抗菌药物管理计划的潜在目标病原体。
