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首页> 美国卫生研究院文献>Journal of Clinical Microbiology >Near Absence of Vancomycin-Resistant Enterococci but High Carriage Rates of Quinolone-Resistant Ampicillin-Resistant Enterococci among Hospitalized Patients and Nonhospitalized Individuals in Sweden
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Near Absence of Vancomycin-Resistant Enterococci but High Carriage Rates of Quinolone-Resistant Ampicillin-Resistant Enterococci among Hospitalized Patients and Nonhospitalized Individuals in Sweden

机译：瑞典住院患者和非住院患者中耐万古霉素的肠球菌几乎不存在但耐喹诺酮的氨苄青霉素的肠球菌的高携带率

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Rates of colonization with enterococci with acquired resistance to vancomycin (vancomycin-resistant enterococci [VRE]) and ampicillin (ampicillin-resistant enterococci [ARE]) were determined by using fecal samples from 670 nonhospitalized individuals and 841 patients in 27 major hospitals. Of the hospitalized patients, 181 (21.5%) were carriers of ARE and 9 (1.1%) were carriers of VRE. In univariate analyses, length of hospital stay (odds ratio [OR], 4.6; 95% confidence interval [CI], 2.5 to 8.9) and antimicrobial therapy (OR, 4.7; 95% CI, 3.3 to 6.7) were associated with ARE colonization, as were prior treatment with penicillins (OR, 3.1; 95% CI, 1.8 to 5.5), cephalosporins (OR, 2.9; 95% CI, 1.7 to 5.0), or quinolones (OR, 2.7; 95% CI, 1.5 to 4.7). In logistic regression analysis, antimicrobial therapy for at least 5 days was independently associated with ARE carriage (adjusted OR, 3.8; 95% CI, 2.6 to 5.4). Over 90% of the ARE isolates were fluoroquinolone resistant, whereas 14% of the ampicillin-susceptible Enterococcus faecium isolates were fluoroquinolone resistant. ARE carriage rates correlated with the use of fluoroquinolones (P = 0.04) but not with the use of ampicillin (P = 0.68) or cephalosporins (P = 0.40). All nine VRE isolates were E. faecium vanB and were found in one hospital. Seven of these isolates were related according to their types as determined by pulsed-field gel electrophoresis. Among the nonhospitalized individuals, the ARE carriage rate was lower (6%; P < 0.05), and only one person, who had recently returned from Africa, harbored VRE (E. faecium vanA). The absence of VRE colonization in nonhospitalized individuals reflects an epidemiological situation in Sweden radically different from that in countries in continental Europe where glycopeptides have been widely used for nonmedical purposes.
机译：通过使用来自27家主要医院的670名非住院患者和841名患者的粪便样本，确定对万古霉素（万古霉素耐药的肠球菌[VRE]）和氨苄西林（对氨苄青霉素耐药的肠球菌[ARE]）具有耐药性的肠球菌定植率。在住院患者中，有181名（21.5％）是ARE携带者，有9名（1.1％）是VRE携带者。在单因素分析中，住院时间（优势比[OR]，4.6； 95％置信区间[CI]，2.5至8.9）和抗菌治疗（OR，4.7； 95％CI，3.3至6.7）与ARE定植有关，与先前使用青霉素（OR，3.1; 95％CI，1.8至5.5），头孢菌素（OR，2.9; 95％CI，1.7至5.0）或喹诺酮类药物（OR，2.7; 95％CI，1.5至4.7）的先前治疗相同）。在逻辑回归分析中，至少5天的抗菌治疗与ARE转运独立相关（校正OR，3.8； 95％CI，2.6至5.4）。超过90％的ARE分离株对氟喹诺酮耐药，而14％的氨苄西林敏感性肠球菌粪便分离株对氟喹诺酮耐药。 ARE携带率与使用氟喹诺酮类药物（P = 0.04）相关，但与使用氨苄西林（P = 0.68）或头孢菌素（P = 0.40）不相关。所有九种VRE分离株均为粪肠球菌，并在一所医院中发现。根据脉冲场凝胶电泳确定的类型，这些分离物中有七个是相关的。在非住院患者中，ARE携带率较低（6％； P <0.05），并且只有一个最近从非洲返回的人携带了VRE（E. faecium v​​anA）。在非住院患者中不存在VRE殖民现象，反映出瑞典的流行病学状况与欧洲大陆上糖肽已广泛用于非医学目的的国家完全不同。

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