Jones R N, Marshall S A, Pfaller M A, Wilke W W, Hollis R J, Erwin M E, Edmond M B, Wenzel R P
Medical Microbiology Division, University of Iowa College of Medicine, Iowa City 52242, USA.
Diagn Microbiol Infect Dis. 1997 Oct;29(2):95-102. doi: 10.1016/s0732-8893(97)00115-6.
Characteristics of nosocomial enterococcal blood stream infection (NEBSI) isolates obtained from patients at 41 U.S. hospitals participating in the SCOPE Program were studied. Isolates from 480 episodes of NEBSI were characterized according to species and antimicrobial susceptibility profile. Selected isolates were also identified to species and vancomycin resistance genotype using polymerase chain reaction based methods. Polymerase chain reaction genotyping and ribotyping were used as genetic markers for molecular epidemiologic typing. Enterococci were the third most common cause of nosocomial blood stream infection in this study, accounting for 11.7% of all isolates reported. Enterococcus faecalis was the most common species (59.6%), followed by E. faecium (19.4%). Species identification errors involving E. faecium, E. durans, E. avium, and E. raffinosus were observed. Vancomycin resistance was observed in 36.4% of all participating medical centers and varied from 11.1% of medical centers in the Northwest to 60.9% of medical centers in the Southwest. Vancomycin-resistant enterococci accounted for 20.6% of NEBSI in the Northeast, 11.4% in the Southeast, 11.1% in the Southwest, and 9.5% in the Northwest regions. VanA genotypes predominated in the Northeast and Southwest, whereas vanA and vanB genotypes were equally prevalent in the Northwest and Southeast. Molecular typing studies identified strains that were unique to individual hospitals as well as strains that were prevalent in several different hospitals. NEBSI with vancomycin-resistant enterococci continues to escalate among hospitalized patients in all geographic areas of the USA.
对参与SCOPE项目的41家美国医院的患者所分离出的医院内肠球菌血流感染（NEBSI）菌株的特征进行了研究。根据菌种和抗菌药物敏感性谱对480例NEBSI发作的分离菌株进行了特征分析。还使用基于聚合酶链反应的方法对选定的分离菌株进行了菌种鉴定和万古霉素耐药基因型鉴定。聚合酶链反应基因分型和核糖体分型用作分子流行病学分型的遗传标记。在本研究中，肠球菌是医院血流感染的第三大常见病因，占所有报告分离菌株的11.7%。粪肠球菌是最常见的菌种（59.6%），其次是屎肠球菌（19.4%）。观察到涉及屎肠球菌、耐久肠球菌、鸟肠球菌和棉子糖肠球菌的菌种鉴定错误。在所有参与的医疗中心中，36.4%观察到万古霉素耐药，范围从西北部医疗中心的11.1%到西南部医疗中心的60.9%。耐万古霉素肠球菌在东北地区的NEBSI中占20.6%，在东南部占11.4%，在西南部占11.1%，在西北部地区占9.5%。VanA基因型在东北部和西南部占主导地位，而VanA和VanB基因型在西北部和东南部同样普遍。分子分型研究确定了个别医院特有的菌株以及在几家不同医院中普遍存在的菌株。耐万古霉素肠球菌引起的NEBSI在美国所有地理区域的住院患者中持续增加。
