Shen Hongwei, Zhang Qiaomin, Li Shaobo, Huang Tingting, Ma Wen, Wang Daming, Li Peng
Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, China.
Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, China.
J Glob Antimicrob Resist. 2025 Jan;40:29-33. doi: 10.1016/j.jgar.2024.11.002. Epub 2024 Nov 20.
To investigate the prevalence and characteristics of vancomycin-resistant Enterococcus (VRE) isolates in a Chinese tertiary hospital in Shenzhen.
A hospital-based retrospective epidemiological survey of Enterococcus was conducted over a 6.5-y period, from January 2018 to June 2024. The VRE isolates were identified and subjected to screening for the six van genes and multi-locus sequence typing (MLST) genotyping. The clinical characteristics, antimicrobial susceptibility profiles and molecular features were subjected to analysis.
A total of 34 non-duplicate VRE isolates were identified, comprising 32 vancomycin-resistant Enterococcus faecium (VREfm) and 2 vancomycin-resistant Enterococcus faecalis (VREfa) strains. Since its initial isolation in 2022, there has been an observable increase in the detection rate of VRE. The detection rate of VRE between 2022 and 2024 (until June) was 0.3%, 4.8%, and 8.6%, respectively. The majority of the VRE strains were isolated from urine (25/34, 73.5%), and the highest detection rate (9.1%) of VRE infections was observed in the patients aged ≥75 y. In excess of 90% of VRE isolates exhibited resistance to ciprofloxacin (97.1%) and levofloxacin (97.1%), followed by ampicillin (94.1%) and penicillin (94.1%). The non-susceptible rate was observed to be low for linezolid (2.9%) and tigecycline (5.9%). Of the 29 VREfm isolates preserved and tested, 28 were found to harbour the vanA gene. A total of six STs were identified among the 29 VREfm isolates, with ST80 (16/29, 55.2%) being the predominant. The ST80 remained the most prevalent clone until the introduction of ST78 in May 2023, at which point these two clones became the most prevalent.
There has been an observable increase in the prevalence of VRE in our hospital since 2022. Furthermore, an ongoing outbreak of ST80 and ST78 VREfm with vanA-harboring plasmid was identified. It is imperative that continuous surveillance be conducted in order to inform public health interventions.
调查深圳一家三级医院耐万古霉素肠球菌（VRE）分离株的流行情况及特征。
于2018年1月至2024年6月的6.5年期间，对肠球菌进行了一项基于医院的回顾性流行病学调查。对VRE分离株进行鉴定，并对6种van基因进行筛查及多位点序列分型（MLST）基因分型。对临床特征、抗菌药物敏感性谱及分子特征进行分析。
共鉴定出34株非重复VRE分离株，包括32株耐万古霉素屎肠球菌（VREfm）和2株耐万古霉素粪肠球菌（VREfa）菌株。自2022年首次分离以来，VRE的检出率呈明显上升趋势。2022年至2024年（截至6月）VRE的检出率分别为0.3%、4.8%和8.6%。大多数VRE菌株分离自尿液（25/34，73.5%），≥75岁患者中VRE感染的检出率最高（9.1%）。超过90%的VRE分离株对环丙沙星（97.1%）和左氧氟沙星（97.1%）耐药，其次是氨苄西林（94.1%）和青霉素（94.1%）。利奈唑胺（2.9%）和替加环素（5.9%）的不敏感率较低。在保存并检测的29株VREfm分离株中，28株携带vanA基因。在29株VREfm分离株中总共鉴定出6种序列型，其中ST80（16/29，55.2%）为主型。直到2023年5月ST78出现之前，ST80一直是最常见的克隆型，此后这两种克隆型成为最常见的。
自2022年以来，我院VRE的流行率呈明显上升趋势。此外，还发现了携带vanA质粒的ST80和ST78 VREfm正在爆发流行。必须持续开展监测以便为公共卫生干预提供依据。
