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在非流行期,确诊癌症患者入院当天直肠拭子中编码vanA/vanB万古霉素耐药性的基因发生率。

Incidence of genes encoding vanA/vanB vancomycin resistance in rectal swabs of patients with diagnosed cancer, on the day of admission to hospital, in a non-epidemic period.

作者信息

Szymankiewicz Maria, Wróblewska Joanna, Nowikiewicz Tomasz

机构信息

Department of Microbiology, Prof. F. Łukaszczyk Centre of Oncology, Bydgoszcz, Poland.

Chair and Clinic of Oncological Surgery, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland.

出版信息

Prz Gastroenterol. 2020;15(3):220-224. doi: 10.5114/pg.2020.98537. Epub 2020 Sep 19.

Abstract

INTRODUCTION

Rapid diagnosis is important for preventing infections due to vancomycin-resistant enterococci.

AIM

To evaluate the status of gastrointestinal colonisation with strains containing vanA/vanB genes in oncological patients.

MATERIAL AND METHODS

A total of 167 samples of rectal swabs taken from 161 patients (mean age: 63, range: 29-93 years) were examined, including 113 patients from surgical wards (70.2%) and 48 patients from non-surgical wards (29.8%), with diagnosed cancer. The tests were carried out within 24 h of admitting the patient to the department, using the Cepheid Xpert vanA/vanB test, with a CE marked GeneXpert Instrument Systems analyser. Samples with positive vanB gene results were additionally seeded on chromogenic media.

RESULTS

The presence of the vanA gene was found in 2.7% and 6.3% of the examined patients, respectively, from the surgical and non-surgical departments, which accounted for 3.7% of all the patients examined. The presence of the vanB gene was detected in 21.1% of the patients, but in no case was there any growth of vancomycin-resistant enterococci on the chromogenic medium.

CONCLUSIONS

Patients admitted to non-surgical wards were more often colonised with vanA/vanB genes than were patients admitted to surgical wards, but the differences were not statistically significant.

摘要

引言

快速诊断对于预防耐万古霉素肠球菌感染很重要。

目的

评估肿瘤患者中携带vanA/vanB基因菌株的胃肠道定植情况。

材料与方法

共检查了161例患者(平均年龄:63岁,范围:29 - 93岁)的167份直肠拭子样本,其中包括113例来自外科病房的患者(70.2%)和48例来自非外科病房的患者(29.8%),均已确诊患有癌症。在患者入院科室后的24小时内进行检测,使用赛沛Xpert vanA/vanB检测,采用带有CE标志的GeneXpert仪器系统分析仪。vanB基因检测结果为阳性的样本另外接种在显色培养基上。

结果

在来自外科和非外科科室的受检患者中,分别有2.7%和6.3%的患者检测到vanA基因,占所有受检患者的3.7%。在21.1%的患者中检测到vanB基因,但在显色培养基上均未发现耐万古霉素肠球菌生长。

结论

入住非外科病房的患者比入住外科病房的患者更常携带vanA/vanB基因,但差异无统计学意义。

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