Control of vancomysin-resistant enterococci in Japan and the study of a combination therapy

日本耐万古霉素肠球菌的控制及联合治疗的研究

• 批准号: 12672214
• 负责人: KARIYAMA Reiko
• 金额: $ 1.09万
• 依托单位: Okayama University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2000
• 资助国家: 日本
• 起止时间: 2000 至 2002
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-12672214/
• 关键词: vancomycin-resistant enterococci; VRE; infection control; detection method; PCR assay; molecular epidemiology; transposon; combination therapy; VRE; バンコマイシン耐性; 腸球菌

The first report in Japan of a vaneomycin-resistant enterococcal clinical isolate was in 1996. Although outbreaks of VariA-type or VanB-type vaneomycin-resistant enterococci (VRE) at some Japanese hospitals were reported, infections or colonizations due to VRE have been rare in Japan until May 2003. In 1998, a patient colonized with VanA-type Enterococcus faecium (VREF) was hospitalized at the Okayama University Hospital (Okayama, Japan). Since then, to control one of the most important nosocomial pathogens, we have studied on detection of VRE, molecular epidemiology of VRE and a combination therapy for VRE.We have developed a simple and reliable multiplex PCR assay for surveillance isolates of VRE. Seven primer sets targeting the genes vanA, vanB, vanCl, vanC2/C3, Enterococcus faecalis-specific, Enterococcus faecium-specific and rrs(l6SrRNA) were used in one reaction tube. The optimized multiplex PCR assay is an attractive alternative to the other methods since it provides simpler and … More more accurate analysis of the molecular epidemiology of VRE isolates.We identified a Tn1546-like (type2) element in VREF isolated from hospitalized patients in Japan. The Tn1545-like (type2) element has previously been associated with VREF isolated from pig feces in Europe. So far, four VRE isolates in Japan possessed the unique molecular variations characteristic of Tn1546-like (type2) element, the presence of an IS1216V-IS3-like element in the left end of Tn1546and a point mutation (G to T) at position 8234 in the essential vanX gene of Tn1546.Optical therapy for serious enterococcal infections requires the combination of a cell wall-active agent with an aminoglycoside (most commonly gentamicin) for synergistic killing. In our studies, the combination of ampicillin and arbekacin demonstrated inhibitory activity against VRE possessing aac(6')-aph(2'') or aph(2'')-Id genes. This combination may prove useful in treating infections caused by multiresistant enterococci, where treatment options are limited. Less

1996年，日本首次报道了耐万古霉素肠球菌临床分离株。尽管在日本的一些医院报告了VariA型或VanB型耐万古霉素肠球菌（VRE）的爆发，但直到2003年5月，VRE引起的感染或定植在日本一直很罕见。1998年，一名被VanA型屎肠球菌（VREF）定殖的患者在冈山大学医院（冈山，日本）住院。此后，为了控制VRE这一重要的医院内病原体，我们对VRE的检测、分子流行病学和联合治疗进行了研究，并建立了一种简便、可靠的VRE监测分离株多重PCR检测方法。在一个反应管中使用靶向基因vanA、vanB、vanCl、vanC 2/C3、粪肠球菌特异性、屎肠球菌特异性和rrs（16 SrRNA）的七个引物组。优化的多重PCR测定是其他方法的有吸引力的替代方法，因为它提供了更简单和更有效的方法。 ...更多信息 我们在从日本住院患者中分离的VREF中鉴定了一个Tn 1546样（2型）元件。Tn 1545样（2型）元件先前已与从欧洲猪粪便中分离的VREF相关。迄今为止，日本的4个VRE分离物具有Tn 1546样（2型）元件的独特分子变异特征，在Tn 1546的左端存在IS 1216 V-IS 3样元件，并且在Tn 1546的必需vanX基因的位置8234处存在点突变（G至T）。活性剂与氨基糖苷类（最常见的是庆大霉素）协同杀灭。在我们的研究中，氨苄青霉素和阿贝卡星的组合显示出对具有aac（6“）-aph（2”）或aph（2“）-Id基因的VRE的抑制活性。这种组合可能被证明在治疗多重耐药肠球菌引起的感染方面是有用的，其中治疗选择有限。少

项目成果

Vivek Kak et al.: "Efficacy of ampicillin plus arbekacin in experimental rabbit endocarditis caused by an Enterococcus faecalis strain with high-level gentamicin resistance."Antimicrobial Agents and Chemotherapy. 44. 2545-2546 (2000)

Vivek Kak 等人：“氨苄西林加阿贝卡星对由具有高水平庆大霉素耐药性的粪肠球菌菌株引起的实验性兔心内膜炎的疗效。”抗菌药物和化疗。

狩山玲子: "検査とその周辺「バンコマイシン耐性腸球菌(VRE)サーベイランスに有用なmultiplex-PCR法」"Infection & Technology. 6. 10-11 (2002)

Reiko Kariyama：“测试及其周围环境“可用于万古霉素耐药肠球菌 (VRE) 监测的多重 PCR 方法””感染与技术。

Reiko Kariyama et al.: "Simple and reliable multiplex-PCR assay for surveillance isolates of vancomycin-resistant enterococci"Journal of Clinical Microbiology. 38. 3092-3095 (2000)

Reiko Kariyama 等人：“用于监测万古霉素耐药肠球菌分离株的简单可靠的多重 PCR 测定”临床微生物学杂志。

Sameer Elsayed et al.: "Improved primer design for multiplex PCR analysis of vancomycin-resistant Enterococcus spp"Journal of Clinical Microbiology. 39. 2367-2368 (2001)

Sameer Elsayed 等人：“万古霉素耐药肠球菌多重 PCR 分析的改进引物设计”临床微生物学杂志。

Kariyama Reiko: "Identification of a Tn1546-like (type 2) element in vancomycin-resistant Enterococcus faecium isolated from hospitalized patients in Japan"Antimicrolial Agents and Chemotherapy. 45・3. 992-993 (2001)

Kariyama Reiko：“从日本住院患者中分离出的耐万古霉素屎肠球菌中的 Tn1546 样（2 型）元件的鉴定”Antimicrolial Agents and Chemotherapy 45・3 (2001)。