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阿卜杜勒阿齐兹国王大学医院耐万古霉素肠球菌的流行病学及临床影响(2015 - 2022年):患病率、危险因素及死亡率

Epidemiology and Clinical Impact of Vancomycin-Resistant Enterococcus at King Abdulaziz University Hospital (2015-2022): Prevalence, Risk Factors, and Mortality.

作者信息

Mokhtar Jawahir A, Attallah Dalya, Al-Rabia Mohammed W, Alqarni Mona Abdulrahman, Alkuwaity Khalil K, Almoghrabi Yousef, Daghistani Hussam, Ismail Mazen A, Sharif Asim T, Redwan Bayan, Ajabnoor Alyaa M, Alharbi Ohood S, Abu Ibrahim Mohammed, Alhazmi Wafaa, Mufrrih Mohammed, Sait Ahmad M, Alfadil Abdelbagi, Daghistani Yassir, Momin Hattan Jamal, Ibrahem Karem

机构信息

Department of Clinical Microbiology and Immunology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.

Department of Clinical Microbiology Laboratory, King Abdulaziz University Hospital, Jeddah, 21589, Saudi Arabia.

出版信息

Int J Gen Med. 2025 Apr 8;18:2021-2031. doi: 10.2147/IJGM.S508262. eCollection 2025.

Abstract

BACKGROUND

and are part of the human microbiota but pose significant risks in clinical settings due to increasing antimicrobial resistance. Vancomycin-resistant enterococci (VRE) are a growing concern, linked to high morbidity and mortality in hospitalized patients.

AIM

This study is the first comprehensive investigation of VRE prevalence and associated risk factors at King Abdulaziz University Hospital (KAUH) from 2015 to 2022.

METHODS

Clinical samples were collected, and VRE isolates were identified using VRE Card GeneXpert, BioFire PCR, and the VITEK 2 system. Descriptive statistical analysis with Stata version 17 summarized patient characteristics, including demographics, comorbidities, hospital exposure, and laboratory findings. Categorical variables were reported as frequencies/percentages, while continuous variables were expressed as mean ± SD or median [IQR].

RESULTS

Among 254 adult patients with VRE infections, the median age was 61 years. The most common comorbidities were diabetes, hypertension, and kidney disease. VRE infections peaked in 2021, with urine cultures being the most frequent source. Most patients had prior antibiotic exposure, particularly to vancomycin and carbapenems. was the predominant species, with the phenotype being most common. Alarmingly, 61.8% of VRE-infected patients died during the study period.

CONCLUSION

These findings underscore the critical need for enhanced infection control measures and antimicrobial stewardship to combat VRE and improve patient outcomes.

摘要

背景

肠球菌属和葡萄球菌属都是人类微生物群的一部分,但由于抗菌药物耐药性不断增加,在临床环境中构成了重大风险。耐万古霉素肠球菌(VRE)日益引起关注,与住院患者的高发病率和死亡率相关。

目的

本研究是对2015年至2022年阿卜杜勒阿齐兹国王大学医院(KAUH)耐万古霉素肠球菌的流行情况及相关危险因素进行的首次全面调查。

方法

收集临床样本,使用VRE卡GeneXpert、BioFire PCR和VITEK 2系统鉴定耐万古霉素肠球菌分离株。使用Stata 17版进行描述性统计分析,总结患者特征,包括人口统计学、合并症、医院暴露情况和实验室检查结果。分类变量以频率/百分比报告,连续变量以均值±标准差或中位数[四分位间距]表示。

结果

在254例耐万古霉素肠球菌感染的成年患者中,中位年龄为61岁。最常见的合并症是糖尿病、高血压和肾脏疾病。耐万古霉素肠球菌感染在2021年达到高峰,尿液培养是最常见的感染源。大多数患者既往有抗生素暴露史,尤其是万古霉素和碳青霉烯类。粪肠球菌是主要菌种,VanA表型最为常见。令人担忧的是,在研究期间,61.8%的耐万古霉素肠球菌感染患者死亡。

结论

这些发现强调了加强感染控制措施和抗菌药物管理以对抗耐万古霉素肠球菌并改善患者预后的迫切需要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c12f/11992994/ec9ac492c83e/IJGM-18-2021-g0001.jpg

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