对万科米辛敏感的Enterococcus faecium细菌病 - - 丹麦大学医院的一家医院的医院传播和死亡率
Sanne Groenvall Kjaer Hansen1,2,3, Louise Roer3, Kasper Thystrup Karstensen3
1Department of Clinical Microbiology and Infection Control, Odense University Hospital, 2nd Floor, J.B. Winsløws Vej 21, 5000 Odense, Denmark.
Journal of medical microbiology
|July 12, 2023
概括
对万科米辛敏感的Enterococcus faecium (VSEfm) 菌株多样化和演变,观察到广泛的医院传播. VSEfm很少导致死亡,而30天死亡率并不反映死亡的实际原因.
科学领域:
- 临床微生物学和传染病.
- 细菌病原体的基因组学和分子流行病学.
背景情况:
- 抗万科胺素的Enterococcus faecium (VREfm) 的出现已经掩盖了对万科胺素敏感的E. faecium (VSEfm).
- 对VSEfm分子特征,传播和临床影响的潜在变化仍未得到充分研究.
- VSEfm可能作为VREfm在医院环境中引入的前体或指标.
研究的目的:
- 为了进行VSEfm分离物的分子特征.
- 确定医院传播模式和VSEfm和VREfm之间的潜在联系.
- 调查VSEfm细菌病的临床影响,包括人口统计,治疗和死亡率.
主要方法:
- 全基因组测序和VSEfm和VREfm血液培养分离物 (2015-2019) 的核心基因组多部位序列类型化 (cgMLST).
- VSEfm和VREfm分离物之间的克隆转移和多样性的比较.
- 对临床数据的医院记录的分析和对VSEfm病例的传播调查.
主要成果:
- 来自599名患者的630个VSEfm分离物表现出显著的多样性 (42个序列类型,131个复杂类型),有广泛传播的证据.
- 在VSEfm和VREfm克隆之间没有发现直接相关性.
- VSEfm细菌病的30天死亡率为40%,但仅在6.3%的病例中是可能导致死亡的原因.
结论:
- VSEfm细菌病分离物显示出不断演变和多样化的分子类型,广泛的医院传播表明病原体传播的潜在风险因素.
- 在VSEfm和VREfm的引入之间没有直接联系.
- 在VSEfm细菌病例中的30天死亡率并不准确地反映死亡原因,因为VSEfm很少是主要原因.
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