为了防止医院感染,重要的是在患者中筛查潜在的耐万古霉素肠球菌(VRE).在这项研究中,我们分析了一家医院住院患者的肠球菌分离株,没有出现明显的VRE.从2021年4月1日至6月30日广岛大学医院的住院患者中使用肠球菌的选择性培养基收集肠球菌分离株。多位点序列分型,抗菌药物敏感性试验,和全基因组测序。共有164个分离株,包括屎肠球菌(41个分离株),粪肠球菌(80株),棉子肠球菌(11个分离株),肠球菌(九种分离株),禽肠球菌(12个分离株),乳酸肠球菌(8个分离株),胆肠球菌(两个分离株),和恶臭肠球菌(一种分离),进行了分析。我们发现了一个vanA阳性的屎肠杆菌,当病人被转移到医院时已经被告知,9个vanC阳性卡塞利黄大肠杆菌,和两个vanC阳性大肠杆菌。屎肠球菌分离株对氨苄西林表现出耐药性(95.1%),亚胺培南(95.1%),和左氧氟沙星(87.8%),粪肠球菌分离株对二甲胺四环素耐药(49.4%)。对氨苄青霉素和左氧氟沙星耐药的屎肠球菌在青霉素结合蛋白5(PBP5)(39/39分离株)和ParC/GyrA(21/36分离株)中有多个突变,分别。E.raffinosus显示对氨苄青霉素的耐药性(81.8%),亚胺培南(45.5%),和左氧氟沙星(45.5%),大肠埃希菌对氨苄西林(37.5%)和亚胺培南(50.0%)耐药。利奈唑胺抗性基因optrA和cfr(B)仅在粪肠球菌和棉虫的一个分离物中发现,分别。这项研究,显示住院患者的肠球菌感染状况,是考虑VRE医院感染控制的重要信息之一。
To prevent nosocomial infection, it is important to screen for potential vancomycin-resistant Enterococcus (VRE) among patients. In this study, we analyzed enterococcal isolates from inpatients in one hospital without any apparent outbreak of VRE. Enterococcal isolates were collected from inpatients at Hiroshima University Hospital from April 1 to June 30, 2021 using selective medium for Enterococci. Multilocus sequence typing, antimicrobial susceptibility testing, and whole-genome sequencing were performed. A total of 164 isolates, including Enterococcus faecium (41 isolates), Enterococcus faecalis (80 isolates), Enterococcus raffinosus (11 isolates), Enterococcus casseliflavus (nine isolates), Enterococcus avium (12 isolates), Enterococcus lactis (eight isolates), Enterococcus gallinarum (two isolates), and Enterococcus malodoratus (one isolate), were analyzed. We found one vanA-positive E. faecium, which was already informed when the patient was transferred to the hospital, nine vanC-positive E. casseliflavus, and two vanC-positive E. gallinarum. E. faecium isolates showed resistance to ampicillin (95.1%), imipenem (95.1%), and levofloxacin (87.8%), and E. faecalis isolates showed resistance to minocycline (49.4%). Ampicillin- and levofloxacin-resistant E. faecium had multiple mutations in penicillin-binding protein 5 (PBP5) (39/39 isolates) and ParC/GyrA (21/36 isolates), respectively. E. raffinosus showed resistance to ampicillin (81.8%), imipenem (45.5%), and levofloxacin (45.5%), and E. lactis showed resistance to ampicillin (37.5%) and imipenem (50.0%). The linezolid resistance genes optrA and cfr(B) were found only in one isolate of E. faecalis and E. raffinosus, respectively. This study, showing the status of enterococci infection in hospitalized patients, is one of the important information when considering nosocomial infection control of VRE.