在台湾南部的万科菌素变异性肠杆菌菌菌病的特征和流行率
Chi-Jung Lu1, Wei-Chun Hung2, Zi-Han Lan3
1Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
概括
菌素变异性肠球菌 (VVE) 在台湾很常见,尽管它们似乎对菌素敏感. 恶性病和中央静脉导管是危险因素,但VVE不会增加死亡率.
科学领域:
- 传染性疾病 传染性疾病
- 临床微生物学 临床微生物学
- 流行病学 流行病学
背景情况:
- 范菌素变异性肠球菌 (VVE) 是具有范菌素敏感表型的范A载体肠球菌 (Enterococcus faecium),具有治疗失败的风险.
- 只有通过分子方法才能检测到VVE,这使感染控制和患者管理复杂化.
- 这项研究调查了台湾南部的VVE的流行率和临床风险因素.
研究的目的:
- 为了确定在Enterococcus faecium bacteremia分离物中菌素变异性肠球菌 (VVE) 的患病率.
- 为了确定与VVE细菌血症相关的临床风险因素.
- 为了评估VVE细菌病的临床结果,与对菌素敏感的Enterococcus faecium (VSE) 相比.
主要方法:
- 在2017年至2021年期间,在台湾南部的两家医院对Enterococcus faecium bacteremia患者进行了回顾性研究.
- VVE分离物中含有vanA基因,但表现出表型的菌素敏感性.
- 对菌素敏感的Enterococcus faecium (VSE) 隔离物缺乏vanA或vanB基因,并且具有表型敏感性.
主要成果:
- 在Enterococcus faecium bacteremia病例中,VVE占14.8% (21/142),其中VSE占85.2% (121/142).
- 在VVE分离物中观察到对青素,四环素和菌素的更高耐药率.
- VVE细菌病的独立风险因素包括恶性瘤 (aOR=4.87) 和中央静脉导管使用 (aOR=4.69);男性性别是保护性 (aOR=0.12).
结论:
- 在台湾南部,在对菌素敏感的Enterococcus faecium bacteremia中,VVE的患病率显著.
- VVE细菌病与30天死亡率的增加没有关联,但有一例病例进展为抗万科胺素的肠球菌感染.
- 建议进行进一步的多中心监测,以评估台湾的VVE对公共卫生的影响.
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