Bager F, Madsen M, Christensen J, Aarestrup F M
Danish Veterinary Laboratory, Copenhagen, Denmark.
Prev Vet Med. 1997 Jul;31(1-2):95-112. doi: 10.1016/s0167-5877(96)01119-1.
We determined the association between the use of the glycopeptide antibiotic avoparcin as a growth promoter and the occurrence of Enterococcus faecium (VREF) with high-level resistance to vancomycin (MIC > or = 64 micrograms ml-1) on poultry and pig farms. The investigations were conducted as retrospective cohort studies, where groups of farms exposed or not exposed to avoparcin between September 1994 and April 1995 were compared. In poultry, the association between the use of avoparcin and the occurrence of VREF was confounded by the use of broad-spectrum antibiotics, and the adjusted relative risk was 2.9 (1.4-5.9). In pigs, the association had a similar magnitude with a non-adjusted relative risk of 3.3 (0.9-12.3). The similar findings in the two studies provide evidence in favour of a causal association between the use of avoparcin and the occurrence of VREF on farms, and suggest that food animals constitute a potential reservoir of infection for VREF in humans.
我们确定了在禽畜养殖场中，使用糖肽类抗生素阿伏帕星作为生长促进剂与出现对万古霉素具有高水平耐药性（最低抑菌浓度≥64微克/毫升）的粪肠球菌（VREF）之间的关联。调查采用回顾性队列研究进行，比较了1994年9月至1995年4月期间接触或未接触阿伏帕星的养殖场组。在禽类中，阿伏帕星的使用与VREF的出现之间的关联因广谱抗生素的使用而混淆，调整后的相对风险为2.9（1.4 - 5.9）。在猪中，这种关联程度相似，未调整的相对风险为3.3（0.9 - 12.3）。两项研究中的相似发现为阿伏帕星的使用与养殖场中VREF的出现之间的因果关联提供了证据，并表明食用动物构成了人类VREF感染的潜在来源。
