Asgin Nergis, Otlu Baris
Department of Medical Microbiology, Faculty of Medicine, Karabuk University, Karabuk, Turkey.
Department of Medical Microbiology, Faculty of Medicine, Inonu University, Malatya, Turkey.
Infect Drug Resist. 2020 Jan 21;13:191-198. doi: 10.2147/IDR.S191881. eCollection 2020.
Vancomycin-resistant enterococci (VRE) have become a global health threat in the last two decades. In this study, we aimed to determine antibiotic resistance using phenotypic and genotypic methods in VRE strains obtained from inpatients and to investigate clonal relatedness among strains.
Identification and antibiotic susceptibility of 47 VRE strains obtained from inpatients at Karabuk University Hospital from 2014 to 2015 were determined using the BD Phoenix™ automated microbiology system. Vancomycin resistance genes (Van A and B) were detected by polymerase chain reaction. Clonal relatedness among the strains was evaluated by pulsed-field gel electrophoresis (PFGE).
All 47 VRE strains obtained from rectal (n=35), blood (n=7), and urine (n=5) samples were confirmed as ; they were resistant to ampicillin, gentamicin, vancomycin, and teicoplanin. One isolate was intermediately resistant to linezolid. No strain was resistant to quinupristin-dalfopristin or daptomycin. Only was detected among strains. According to the PFGE results, 31 of 47 strains were clonally related with a clustering rate of 66%. No common clone was detected.
VRE infections are associated with high mortality, morbidity, and healthcare expenditures. Increasing resistance to last-line drugs, such as linezolid and daptomycin, among VRE strains is a great concern. Therefore, comprehensive measures should be performed to reduce VRE colonization. Although there was no common clone VRE outbreak, polyclonal spread was observed in our hospital. The high clustering rate indicated cross-contamination. Thus, a more effective infection control program should be implemented.
在过去二十年中，耐万古霉素肠球菌（VRE）已成为全球健康威胁。在本研究中，我们旨在使用表型和基因型方法确定从住院患者中分离出的VRE菌株的抗生素耐药性，并调查菌株之间的克隆相关性。
使用BD Phoenix™自动化微生物系统确定2014年至2015年从卡拉布克大学医院住院患者中获得的47株VRE菌株的鉴定和抗生素敏感性。通过聚合酶链反应检测万古霉素耐药基因（Van A和B）。通过脉冲场凝胶电泳（PFGE）评估菌株之间的克隆相关性。
从直肠（n = 35）、血液（n = 7）和尿液（n = 5）样本中获得的所有47株VRE菌株均被确认为；它们对氨苄西林、庆大霉素、万古霉素和替考拉宁耐药。1株分离株对利奈唑胺中度耐药。没有菌株对奎奴普丁-达福普汀或达托霉素耐药。在菌株中仅检测到。根据PFGE结果，47株菌株中有31株具有克隆相关性，聚类率为66%。未检测到共同克隆。
VRE感染与高死亡率、发病率和医疗保健支出相关。VRE菌株对利奈唑胺和达托霉素等一线药物的耐药性增加是一个重大问题。因此，应采取综合措施以减少VRE定植。尽管没有VRE暴发的共同克隆，但在我们医院观察到多克隆传播。高聚类率表明存在交叉污染。因此，应实施更有效的感染控制计划。
