Pearce C L, Evans M K, Peters S M, Cole M F
Department of Microbiology and Immunology and the Department of Laboratory Medicine, Georgetown University Medical Center, Washington, DC 20007, USA.
Am J Infect Control. 1998 Dec;26(6):563-8. doi: 10.1053/ic.1998.v26.a91614.
Enterococci have become important nosocomial pathogens and now account for approximately 12% of nosocomial infections. Enterococci can be transferred from patient to patient and from health care personnel to patient. We investigated the clonal diversity of vancomycinresistant enterococci (VRE) causing an outbreak of infections and attempted to determine the patterns of spread of these bacteria in a university hospital.
Ribotyping was used to examine the clonal diversity of 50 VRE isolates, including 23 from wounds, 14 from urine, 8 from blood, 3 from the rectum, 1 from drainage, and 1 from the cornea.
Nine patients were infected with Enterococcus faecalis, 10 with Enterococcus faecium, 3 with both E faecalis and E faecium, and 1 with Enterococcus avium. The results suggest that the sources of the VRE infections included endogenous strains and strains acquired by transmission from attending staff or from the environment. Three patients were infected by both nosocomial and endogenous strains.
These data suggest that the collection and analysis of several isolates from repeated specimens is necessary to obtain a fuller understanding of the epidemiology and population structure of antibiotic-resistant enterococci.
肠球菌已成为重要的医院病原体，目前约占医院感染的12%。肠球菌可在患者之间以及医护人员与患者之间传播。我们调查了引起感染暴发的耐万古霉素肠球菌（VRE）的克隆多样性，并试图确定这些细菌在一家大学医院中的传播模式。
采用核糖体分型法检测50株VRE分离株的克隆多样性，其中23株来自伤口，14株来自尿液，8株来自血液，3株来自直肠，1株来自引流液，1株来自角膜。
9例患者感染粪肠球菌，10例感染屎肠球菌，3例同时感染粪肠球菌和屎肠球菌，1例感染鸟肠球菌。结果表明，VRE感染的来源包括内源性菌株以及通过从医护人员或环境传播而获得的菌株。3例患者同时感染了医院内源性菌株和外源性菌株。
这些数据表明，有必要从重复标本中收集和分析多个分离株，以更全面地了解耐抗生素肠球菌的流行病学和种群结构。
