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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2018.1
- 수록면
- 226 - 234 (9page)
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Background: Enterococcus faecium, especially vancomycin-resistant E. faecium (VREfm), is a major concern for patients with hematologic diseases. Exposure to antibiotics including fluoroquinolone, which is used as a routine prophylaxis for patients with hematologic (MH) diseases, has been reported to be a risk factor for infection with vancomycin-resistant eneterocci. We compared the characteristics of E. faecium isolates according to their vancomycin susceptibility and patient group (MH vs non-MH patients). Methods: A total of 120 E. faecium bacteremic isolates (84 from MH and 36 from non- MH patients) were collected consecutively, and their characteristics (susceptibility, multilocus sequence type [MLST], Tn1546 type, and the presence of virulence genes and plasmids) were determined. Results: Among the vancomycin-susceptible E. faecium (VSEfm) isolates, resistance to ampicillin (97.6% vs 61.1%) and high-level gentamicin (71.4% vs 38.9%) was significantly higher in isolates from MH patients than in those from non-MH patients. Notably, hyl, esp, and pEF1071 were present only in isolates with ampicillin resistance. Among the VREfm isolates, ST230 (33.3%) and ST17 (26.2%) were predominant in MH patients, while ST17 (61.1%) was predominant in non-MH patients. Plasmid pLG1 was more prevalent in E. faecium isolates from MH patients than in those from non-MH patients, regardless of vancomycin resistance. Transposon analysis revealed five types across all VREfm isolates. Conclusions: The antimicrobial resistance profiles and molecular characteristics of E. faecium isolates differed according to the underlying diseases of patients within the same hospital. We hypothesize that the prophylactic use of fluoroquinolone might have an effect on these differences.
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참고문헌 (30)
참고문헌 신청
Wisplinghoff H / 2004 / Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study / Clin Infect Dis 39:309~317
Cho SY / 2013 / Impact of vancomycin resistance on mortality in neutropenic patients with enterococcal bloodstream infection: a retrospective study / BMC Infect Dis 13:504
권재철 / 2013 / Epidemiology and Clinical Features of Bloodstream Infections in Hematology Wards: One Year Experience at the Catholic Blood and Marrow Transplantation Center / Infection and Chemotherapy 45(1):51~61
Vergis EN / 2001 / Determinants of vancomycin resistance and mortality rates in enterococcal bacteremia. a prospective multicenter study / Ann Intern Med 135:484~492
Peel T / 2012 / Differing risk factors for vancomycin-resistant and vancomycin-sensitive enterococcal bacteraemia / Clin Microbiol Infect 18:388~394
Cho SY / 2013 / Impact of vancomycin resistance on mortality in neutropenic patients with enterococcal bloodstream infection: a retrospective study / BMC Infect Dis 13:504
권재철 / 2013 / Epidemiology and Clinical Features of Bloodstream Infections in Hematology Wards: One Year Experience at the Catholic Blood and Marrow Transplantation Center / Infection and Chemotherapy 45(1):51~61
Vergis EN / 2001 / Determinants of vancomycin resistance and mortality rates in enterococcal bacteremia. a prospective multicenter study / Ann Intern Med 135:484~492
Peel T / 2012 / Differing risk factors for vancomycin-resistant and vancomycin-sensitive enterococcal bacteraemia / Clin Microbiol Infect 18:388~394
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