バンコマイシン耐性腸内球菌による患者および環境のコロニー化の流行病学
M J Bonten1, M K Hayden, C Nathan
1Division of Infectious Diseases, Cook County Hospital, Chicago, Illinois, USA.
Lancet (London, England)
|December 14, 1996
まとめ
集中治療室でのバンコミシン耐性腸球菌 (VRE) の頻繁なコロニゼーションとクロスコロニゼーションは,VREの拡散の重要な要因です. 持続的なVREの植民地化と環境汚染は,その固有の性質に貢献しています.
科学分野:
- 感染症 感染症は感染症です.
- エピデミオロジー エピデミオロジー
- クリティカルケア・メディシン
背景:
- バンコマイシン耐性腸内球菌 (VRE) は,病床病原体としてますます認識されています.
- VREの疫学に関する理解が限られているため,植民地の発生源を調査することが必要である.
研究 の 目的:
- 患者によるコロニー化とVREによる環境汚染を,地方的な環境で調査する.
- VREの植民地化に寄与する異なる源の相対的な重要性を評価する.
主な方法:
- 医療集中治療室 (MICU) に新たに入院した患者の体部や環境表面からの毎日の培養.
- 換気のないMICU患者からの直腸培養.
- パルスフィールドゲル電泳を用いたVRE単離物のストレントイピング.
主要な成果:
- VREのコロニゼーションは,換気患者 (24%) と非換気患者 (6%) と比較して,入院時により頻繁に発生しました.
- コロニー化されていない呼吸器患者の41%がMICU滞在中にVREを取得し,85%がクロスコロニー化に起因しました.
- VREは環境培養の12%で検出され,13人の患者の部屋が汚染されましたが,その後の獲得は低いものでした (23%).
結論:
- MICUの入院時に頻繁に発生するVREのコロニー化とクロスコロニー化が,固有のVREの蔓延の重要な要因である.
- 持続的な胃腸と皮膚のコロニー化,多様なVRE株,環境汚染がVREの伝播に寄与している可能性が高い.
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