Brown A R, Amyes S G, Paton R, Plant W D, Stevenson G M, Winney R J, Miles R S
Department of Medical Microbiology, Edinburgh University Medical School.
J Hosp Infect. 1998 Oct;40(2):115-24. doi: 10.1016/s0195-6701(98)90090-1.
This study reports an outbreak of infection and colonization caused by vancomycin-resistant enterococci (VRE) in the renal service of a large teaching hospital. The polymerase chain reaction and pulsed-field gel electrophoresis were used to study the epidemiology of 26/34 strains of vancomycin-resistant Enterococcus faecalis and Enterococcus faecium from the outbreak in comparison with five strains from other hospitals in Edinburgh and the Borders, and three from other wards in the Royal Infirmary. The study revealed a heterogeneous population of vancomycin-resistant E. faecalis. Over 60% of E. faecium isolates had matching pulsed-field gel electrophoresis patterns and all of these were of VanA phenotype. These results suggest that clonal spread of VanA phenotype E. faecium within and possibly between hospitals is the major vancomycin-resistant enterococcal problem in Edinburgh. Screening of patients and isolation of colonized and infected patients appear to have been successful in controlling the spread of VRE.
本研究报告了一家大型教学医院肾脏科发生的耐万古霉素肠球菌（VRE）感染和定植暴发情况。采用聚合酶链反应和脉冲场凝胶电泳技术，对此次暴发中分离出的26/34株耐万古霉素粪肠球菌和屎肠球菌的流行病学特征进行研究，并与爱丁堡和边境地区其他医院的5株菌株以及皇家医院其他病房的3株菌株进行比较。研究发现耐万古霉素粪肠球菌群体具有异质性。超过60%的屎肠球菌分离株具有匹配的脉冲场凝胶电泳图谱，且所有这些分离株均为VanA表型。这些结果表明，VanA表型屎肠球菌在医院内部以及可能在医院之间的克隆传播是爱丁堡耐万古霉素肠球菌的主要问题。对患者进行筛查以及隔离定植和感染患者似乎已成功控制了VRE的传播。
