Abstract：
OBJECTIVE: We analysed 4 y of laboratory data to characterise the species and determine the antimicrobial susceptibility profiles of enterococci as human pathogens in Fiji. The study also investigated the molecular epidemiology amongst the subset of vancomycin-resistant enterococci (VRE).
METHODS: This retrospective study reviewed bacteriological data from Colonial War Memorial Hospital (CWMH) and other healthcare facilities in the Central and Eastern divisions of Fiji. Phenotypic, antimicrobial susceptibility and vanA and vanB PCR testing were performed using locally approved protocols. The first clinical isolates per patient with antimicrobial susceptibility testing results in a single year were included in the analysis. Data was analysed using WHONET software and Microsoft Excel.
RESULTS: A total of 1817 enterococcal isolates were reported, 1415 from CWMH and 402 from other healthcare facilities. The majority of isolates, 75% (n = 1362) were reported as undifferentiated Enterococcus spp., 17.8% (n = 324) were specifically identified as Enterococcus faecalis and 6.7% (n = 122) as E. faecium. Overall, 10% of the enterococci isolates were from blood cultures. Among isolates from CWMH, <15% of E. faecium were susceptible to ampicillin, and 17.2% were vancomycin resistant. Overall, 874 enterococcal isolates (including the undifferentiated species) were tested against vancomycin, of which 4.8% (n = 42) were resistance. All of the VRE isolates tested (n = 15) expressed vanA genes.
CONCLUSIONS: This study demonstrates the clinical importance of VRE, particularly van A E. faecium in the national referral hospital in Fiji. Enhanced phenotypic and molecular surveillance data are needed to better understand enterococci epidemiology and help guide specific infection prevention and control measures and antibiotic prescribing guidelines.
METHODS: This retrospective study reviewed bacteriological data from Colonial War Memorial Hospital (CWMH) and other healthcare facilities in the Central and Eastern divisions of Fiji. Phenotypic, antimicrobial susceptibility and vanA and vanB PCR testing were performed using locally approved protocols. The first clinical isolates per patient with antimicrobial susceptibility testing results in a single year were included in the analysis. Data was analysed using WHONET software and Microsoft Excel.
RESULTS: A total of 1817 enterococcal isolates were reported, 1415 from CWMH and 402 from other healthcare facilities. The majority of isolates, 75% (n = 1362) were reported as undifferentiated Enterococcus spp., 17.8% (n = 324) were specifically identified as Enterococcus faecalis and 6.7% (n = 122) as E. faecium. Overall, 10% of the enterococci isolates were from blood cultures. Among isolates from CWMH, <15% of E. faecium were susceptible to ampicillin, and 17.2% were vancomycin resistant. Overall, 874 enterococcal isolates (including the undifferentiated species) were tested against vancomycin, of which 4.8% (n = 42) were resistance. All of the VRE isolates tested (n = 15) expressed vanA genes.
CONCLUSIONS: This study demonstrates the clinical importance of VRE, particularly van A E. faecium in the national referral hospital in Fiji. Enhanced phenotypic and molecular surveillance data are needed to better understand enterococci epidemiology and help guide specific infection prevention and control measures and antibiotic prescribing guidelines.
摘要：
目的：我们分析了四年的实验室数据，以表征该物种并确定斐济肠球菌作为人类病原体的抗菌敏感性。该研究还调查了万古霉素耐药肠球菌（VRE）的分子流行病学。
方法：这项回顾性研究回顾了斐济中部和东部地区殖民地战争纪念医院（CWMH）和其他医疗机构的细菌学数据。表型，使用当地批准的方案进行抗菌药物敏感性以及vanA和vanBPCR检测.分析中包括每位患者在一年中具有抗菌药物敏感性测试结果的第一批临床分离株。使用WHONET软件和MicrosoftExcel分析数据。
结果：共报告了1,817株肠球菌分离株，来自CWMH的1415和来自其他医疗机构的402。大多数分离株，75%(n=1362)报告为未分化肠球菌属。,17.8%(n=324)被具体鉴定为粪肠球菌,6.7%(n=122)被鉴定为粪肠球菌。总的来说,10％的肠球菌分离株来自血液培养物。在来自CWMH的分离株中，<15%的屎肠球菌对氨苄西林敏感，万古霉素耐药率为17.2%。总的来说,对874株肠球菌分离株（包括未分化物种）进行了抗万古霉素试验，其中4.8%(n=42)为抗性。所有测试的VRE分离物(n=15)表达vanA基因。
结论：这项研究证明了VRE的临床重要性，特别是在斐济国家转诊医院的vanAE.faecium。需要增强的表型和分子监测数据，以更好地了解肠球菌流行病学，并帮助指导特定的感染预防和控制措施以及抗生素处方指南。
方法：这项回顾性研究回顾了斐济中部和东部地区殖民地战争纪念医院（CWMH）和其他医疗机构的细菌学数据。表型，使用当地批准的方案进行抗菌药物敏感性以及vanA和vanBPCR检测.分析中包括每位患者在一年中具有抗菌药物敏感性测试结果的第一批临床分离株。使用WHONET软件和MicrosoftExcel分析数据。
结果：共报告了1,817株肠球菌分离株，来自CWMH的1415和来自其他医疗机构的402。大多数分离株，75%(n=1362)报告为未分化肠球菌属。,17.8%(n=324)被具体鉴定为粪肠球菌,6.7%(n=122)被鉴定为粪肠球菌。总的来说,10％的肠球菌分离株来自血液培养物。在来自CWMH的分离株中，<15%的屎肠球菌对氨苄西林敏感，万古霉素耐药率为17.2%。总的来说,对874株肠球菌分离株（包括未分化物种）进行了抗万古霉素试验，其中4.8%(n=42)为抗性。所有测试的VRE分离物(n=15)表达vanA基因。
结论：这项研究证明了VRE的临床重要性，特别是在斐济国家转诊医院的vanAE.faecium。需要增强的表型和分子监测数据，以更好地了解肠球菌流行病学，并帮助指导特定的感染预防和控制措施以及抗生素处方指南。
