土耳其一家大学教学医院儿科病房的VRE暴发感染报告

David

J Antimicrob Chemother. 2008 Mar 4 [Epub ahead of print] Links
Nosocomial outbreak of vancomycin-resistant Enterococcus faecium in a paediatric unit at a Turkish university hospital.
土耳其一家大学教学医院儿科病房的VRE暴发感染报告
Ergani-Ozcan A, Naas T, Baysan BO, Ogunc D, Inan D, Colak D, Nordmann P.
Medical Microbiology Department, Akdeniz University School of Medicine, Antalya, Turkey;

Background Despite growing concern about vancomycin-resistant enterococci (VRE) as nosocomial pathogens, especially in the USA, they have been rarely isolated in Turkish hospitals. After initial description in 2001 of unrelated VRE isolates, we report now the molecular characterization of a nosocomial outbreak at the Akdeniz University Hospital, Antalya, Turkey. Methods VRE isolates were from either clinical or rectal swab specimens. Identification, susceptibility testing and molecular characterization were performed according to standard techniques. Virulence genes (encoding aggregation substance, gelatinase, cytolysin, enterococcal surface protein and hyaluronidase) were sought by PCR. Results Thirty-six VRE were isolated from 10 patients between June and October 2005 in the Department of Paediatrics. Six patients were only carriers, two had urinary tract infections and two had bloodstream infections. All isolates were Enterococcus faecium, of vanA genotype and belonged either to a main pulsotype (A) or to three minor pulsotypes (B, C and D). The epidemic strain A, found in eight patients, expressed high-level glycopeptide resistance (MIC of vancomycin 256 mg/L and MIC of teicoplanin 64 mg/L) and was of multilocus sequence typing sequence type (ST) 31, whereas the minor strain D, found in two patients, expressed heterogeneous glycopeptide resistance (MIC of vancomycin 8 to 256 mg/L) and was ST18. Strains B and C were only found in single patients either with strain A or alone. The two epidemic strains A and D were esp gene-positive. Their vanA genes were located on transposons similar to Tn1546, except for deletion of the transposition genes and the presence of IS1542, inserted upstream of the vanA operon, and IS1216, inserted at the 3' end of the vanX gene. VRE outbreak was contained by early identification and implementation of measures for patient isolation and of stringent hand and environmental disinfection policies. Conclusions This work underlines the emergence in Turkey of epidemic VRE clones that belong to the clonal complex-17 (CC-17) and that are esp-positive.

绿茵场

谢分享，很好的文章，激励着我偶尔还照顾下英文！;P :handshake

月光海岸

也很想学习，可不懂英文，能否照顾一下;P ;P

麦苗

好,谢谢

绿茵场

，月版真是逗啊。:lol
我也想有个JJ、GG照顾我呢！:lol

桂花香

谢分享！看了下摘要，感觉分子生物学的东东不太懂。