Microbiology Laboratory. Van Training and Research Hospital, 65300, Van, Turkey.
Department of Microbiology, Van Yüzüncü Yıl University, Medical Faculty, 65080, Van, Turkey.
Afr Health Sci. 2021 Dec;21(4):1662-1668. doi: 10.4314/ahs.v21i4.20.
Multi-drug resistant organisms, especially Vancomycin-Resistant Enterococcus (VRE) and Carbapenam Resistant Klebsiella pneumoniae (KPC), are serious health threat. Early detection of resistant bacteria colonization among patients in intensive care units (ICUs) not only enables effective treatment but more importantly prevents disease and limits transmission. Therefore, we aimed to to assess the frequency of VRE and KPC colonization via rectal swab sampling.
The study was carried out in ICUs of a tertiary hospital. Two rectal swab samples were collected within the first 24 hours of admission and another one was taken every subsequent 15 days to test for for VRE and KPC carriage.
A total 316 rectal swab samples taken from 230 patients. Forty-seven patients were screened at least 2 times. 183 patients were not further screened due to discharge, exitus or transfer to other wards. Thirty-six patients (16%) were determined to be VRE (+). The most frequently isolated strain was E. faecium (80.5%) and its most common genotype was VanA (87.5%). Seven patients (3%) were identified as KPC (+). OXA-48 type crbapenamase was confirmed in all KPC isolates.
This study shows that VRE and KPC colonization continues to be a serious threat in ICUs.
多药耐药菌，尤其是耐万古霉素肠球菌（VRE）和耐碳青霉烯类肺炎克雷伯菌（KPC），对健康构成严重威胁。早期发现重症监护病房（ICU）患者的耐药菌定植，不仅能有效治疗，更重要的是能预防疾病和限制传播。因此，我们旨在通过直肠拭子取样来评估 VRE 和 KPC 定植的频率。
该研究在一家三级医院的 ICU 进行。在入院后的前 24 小时内采集两个直肠拭子样本，此后每 15 天采集一个样本，以检测 VRE 和 KPC 携带情况。
共采集了 230 名患者的 316 个直肠拭子样本。47 名患者至少筛查了 2 次。由于出院、死亡或转至其他病房，183 名患者未进一步筛查。36 名患者（16%）被确定为 VRE（+）。最常分离到的菌株为屎肠球菌（80.5%），其最常见的基因型为 VanA（87.5%）。7 名患者（3%）被确定为 KPC（+）。所有 KPC 分离株均证实携带 OXA-48 型碳青霉烯酶。
本研究表明，VRE 和 KPC 定植在 ICU 中仍然是一个严重威胁。
