The emergence of multi-resistant Enterococcus faecalis clonal complex, CC4, causing nosocomial infections
The emergence of multi-resistant Enterococcus faecalis clonal complex, CC4, causing nosocomial infections
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多重耐药粪肠球菌克隆复合体CC4的出现，引起医院感染
DOI：
10.1099/jmm.0.000761
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发表时间：
2018
影响因子：
3
通讯作者：
Zeng Hui
中科院分区：
文献类型：
--
作者：
Dai Dongfa;Wang Huizhu;Xu Xinmin;Chen Chen;Song Chuan;Jiang Dong;Du Pengcheng;Zhang Yuanyuan;Zeng Hui
目的。粪肠球菌通常是一种肠道共生细菌，但一些谱系引起了越来越多的胃肠道外感染。特别是，具有高毒力或抗菌素耐药性的菌株作为医院病原体在卫生保健机构中普遍存在。本研究旨在阐明大肠杆菌的流行病学特征和抗菌药物敏感性。方法：收集2011 - 2014年某三级医院14个不同病房患者中引起胃肠外感染的77株分离菌。通过多位点序列分型和多位点可变数串联重复序列分析来评估群体关系。结果分离菌株对四环素（86.5%）、红霉素（78.4%）、利福平（62.2%）等耐药。主要克隆配合物包括CC4、CC16和CC21。CC16是最主要的亚型，几乎在所有病房和所有类型的样本中都有检测到，但分离率不断下降。相比之下，CC4和CC21的分离率有所增加，2014年这两种cc的比例是2011年的3倍多。CC4的耐药水平高于cc16。本研究证实了大肠杆菌的流行亚型和抗性谱。提示CC4可能是一个新出现的高风险、多重耐药聚集性病例。迫切需要更多的监测，这将增加我们对预防和治疗此类感染的了解。
Purpose.Enterococcus faecalisis commonly found as a commensal gut bacteria, but some linages have caused increasing extra-gastrointestinal infections. In particular, strains with high-level virulence or antimicrobial resistance are prevalent in healthcare settings as nosocomial pathogens. This study was performed to elucidate the epidemiological characteristics and antimicrobial susceptibility profiles ofE. faecaliscausing nosocomial infections in a Chinese general hospital over a 4-year period.Methodology.We collected 77 isolates causing extra-gastrointestinal infections from patients at 14 different wards in a tertiary hospital from 2011 to 2014. The population relationship was assessed by multilocus sequence typing and multilocus variable-number tandem repeat analysis. The Kirby–Bauer disk diffusion method was used to evaluate susceptibility against 11 antimicrobial agents.Results.The isolates showed high-level resistance to tetracycline (86.5 %), erythromycin (78.4 %), rifampin (62.2 %), etc. The major clonal complexes (CCs) included CC4, CC16 and CC21. As the most dominant subtype, CC16 was identified in almost all of the wards and all types of samples, but the isolation rate decreased continually. In contrast, the isolation rates of CC4 and CC21 increased and the proportion of these two CCs in 2014 was more than three times that in 2011. In addition, CC4 showed higher resistance than CC16.Conclusions.This study demonstrated the prevalent subtypes and resistance profiles ofE. faecaliscausing nosocomial infection, and indicated that CC4 may be a newly emerging high-risk, multi-resistant cluster. More surveillance is urgently needed, which will increase our understanding of the prevention and treatment of such infections.