Savor C, Pfaller M A, Kruszynski J A, Hollis R J, Noskin G A, Peterson L R
Department of Medicine, Northwestern University, Northwestern Memorial Hospital and Northwestern University, Chicago, Illinois, USA.
J Clin Microbiol. 1998 Nov;36(11):3327-31. doi: 10.1128/JCM.36.11.3327-3331.1998.
Genomic DNA extracted from 45 vancomycin-resistant Enterococcus faecium (VRE) isolates was cleaved with HindIII and HaeIII and subjected to agarose gel electrophoresis. The ability of this method (restriction endonuclease analysis [REA]) to distinguish strains at the subspecies level was compared with results previously determined by pulsed-field gel electrophoresis (PFGE). Chart reviews were performed to provide a clinical correlation of possible epidemiologic relatedness. A likely clinical association was found for 29 patients as part of two outbreaks. REA found 21 of 21 isolates were the same type in the first outbreak, with PFGE calling 19 strains the same type. In the second outbreak with eight patient isolates, HindIII found six were the same type and two were unique types. HaeIII found three strains were the same type, two strains were a separate type, and three more strains were unique types, while PFGE found three were the same type and five were unique types. No single "ideal" method can be used without clinical epidemiologic investigation, but any of these techniques is helpful in providing focus to infection control practitioners assessing possible outbreaks of nosocomial infection.
从45株耐万古霉素屎肠球菌（VRE）分离株中提取基因组DNA，用HindIII和HaeIII进行酶切，然后进行琼脂糖凝胶电泳。将该方法（限制性内切酶分析[REA]）在亚种水平区分菌株的能力与先前通过脉冲场凝胶电泳（PFGE）确定的结果进行比较。进行病历审查以提供可能的流行病学相关性的临床关联。作为两次暴发的一部分，发现29例患者存在可能的临床关联。在第一次暴发中，REA发现21株分离株中有21株为同一类型，PFGE称19株菌株为同一类型。在第二次暴发中有8株患者分离株，HindIII发现6株为同一类型，2株为独特类型。HaeIII发现3株为同一类型，2株为另一类型，另有3株为独特类型，而PFGE发现3株为同一类型，5株为独特类型。如果没有临床流行病学调查，没有单一的“理想”方法可以使用，但这些技术中的任何一种都有助于为评估医院感染可能暴发的感染控制从业者提供重点。
