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首页> 外文期刊>Ceylon Medical Journal >Vancomycin resistant enterococcal (VRE) colonization among patients treated in intensive care units at the National Hospital of Sri Lanka, and determination of genotype/s responsible for resistance
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Vancomycin resistant enterococcal (VRE) colonization among patients treated in intensive care units at the National Hospital of Sri Lanka, and determination of genotype/s responsible for resistance

机译：在斯里兰卡国家医院的重症监护病房接受治疗的患者中，万古霉素耐药的肠球菌（VRE）定植，并确定引起耐药的基因型

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Background The aim of this study was to assess the epidemiology of VRE colonization among patients in the intensive care units (ICU) of the National Hospital of Sri Lanka (NHSL).MethodsA cross sectional study was carried out on 218 patients admitted to 12 ICUs of the NHSL from January to March 2012. Rectal swabs were collected on day 0, 4, 8 and every 4th day thereafter till discharge. Enterococci were isolated on selective media and identified up to species level using standard bacteriological procedures. Standardized disc diffusion antibiotic susceptibility testing to ampicillin, teicoplanin and vancomycin was performed using the Clinical and Laboratory Standards Institute (CLSI) method. Minimum inhibitory concentrations to vancomycin were determined, using the E-test in strains showing intermediate or frank resistance to vancomycin by disc diffusion. Genotype determination (van A / van B) was carried out on isolates identified as VRE using the polymerase chain reaction. Patients positive for VRE colonization were followed up to discharge or death.ResultsVRE prevalence in the study sample was 5%. Univariate analysis showed that the use of metronidazole (odds ratio [OR] :15.73;95% 95% confidence interval [CI] : 3.94-62.67,P<0.05) or teicoplanin (OR: 12.56; 95% CI:2.65 – 59.52, p< 0.05) and diabetes (OR: 05.13; 95% CI: 1.36 – 18.7, p< 0.05) or hemodialysis during ICU stay (OR: 7.38 ;95% CI : 1.69-32.16, P<0.05) were associated with an increased risk of VRE colonization.Conclusion The 5% prevalence of VRE colonization detected signals the emergence of VRE in the intensive care setting in Sri Lanka.
机译：背景本研究的目的是评估斯里兰卡国立医院（NHSL）重症监护病房（ICU）患者VRE定植的流行病学方法。 NHSL从2012年1月至2012年3月。在第0、4、8天以及此后的第4天收集直肠拭子，直至出院。肠球菌在选择性培养基上分离，并使用标准细菌学方法鉴定至种水平。使用临床和实验室标准协会（CLSI）方法对氨苄青霉素，替考拉宁和万古霉素进行标准化的椎间盘扩散抗生素敏感性测试。在通过圆盘扩散显示对万古霉素具有中等或坦率抗性的菌株中，使用E检验确定对万古霉素的最低抑制浓度。使用聚合酶链反应对鉴定为VRE的分离株进行基因型测定（van A / van B）。对VRE定植阳性的患者进行随访，直至出院或死亡。结果研究样本中的VRE患病率为5％。单因素分析表明，使用甲硝唑（赔率[OR]：15.73; 95％95％置信区间[CI]：3.94-62.67，P <0.05）或替考拉宁（OR：12.56; 95％CI：2.65 – 59.52， p <0.05）和ICU住院期间的血液透析（OR：7.38; 95％CI：1.69-32.16，P <0.05）和糖尿病（OR：05.13; 95％CI：1.36-18.7，p <0.05）或血液透析与病情增加相关结论在斯里兰卡的重症监护环境中，检测到的VRE发生率为5％，这预示着VRE的出现。

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