Lloyd S, Zervos M, Mahayni R, Lundstrom T
Wayne State University, Rehabilitation Institute of Michigan, Detroit 48201, USA.
Am J Infect Control. 1998 Feb;26(1):35-9. doi: 10.1016/s0196-6553(98)70059-8.
We attempted to define the risk factors for urinary tract acquisition of enterococcus in a 155-bed rehabilitation facility in Southeastern Michigan by performing a prospective, case-controlled observational study.
All cases were identified from daily review of microbiologic records of urine culture results. All urinary isolates of enterococcus species, whether representing infection or colonization, were saved on agar plates for subsequent pulsed-field gel electrophoresis. Thirty-five percent of urinary tract isolates were due to enterococcal species compared with 5% to 15% in adjacent acute-care facilities. A control was defined as the next patient with a nonenterococcal urinary isolate.
No differences were found between cases and controls with respect to age, sex, admitting diagnosis, voiding habits, symptoms, laboratory values, geographic location, caregivers, or urinary infection versus colonization.
Prior antibiotic use was more frequent in the patients colonized or infected with enterococcal isolates (78% vs 41%). No evidence was found for a single clone of enterococcal isolates in our facility by DNA analysis, suggesting that the acquisition of enterococcus in the urinary tract was endogenous.
我们通过开展一项前瞻性病例对照观察性研究，试图确定密歇根州东南部一家拥有155张床位的康复机构中尿路获得肠球菌的危险因素。
所有病例均通过每日审查尿培养结果的微生物学记录来确定。所有肠球菌属的尿液分离株，无论代表感染还是定植，均保存在琼脂平板上，用于后续的脉冲场凝胶电泳。35%的尿路分离株归因于肠球菌属，而相邻急性护理机构中的这一比例为5%至15%。将下一位有非肠球菌属尿液分离株的患者定义为对照。
病例组和对照组在年龄、性别、入院诊断、排尿习惯、症状、实验室值、地理位置、护理人员或尿路感染与定植方面均未发现差异。
定植或感染肠球菌分离株的患者先前使用抗生素的频率更高（78%对41%）。通过DNA分析，我们未发现本机构中存在单一克隆的肠球菌分离株，这表明尿路中肠球菌的获得是内源性的。
