投稿分類 微生物

主委發表種類: 壁報

投稿標題(中): 某醫學中心將多基因位點序列(MLST)分型技術運用在萬古黴素抗藥性的糞腸球菌。

投稿標題(英): Multilocus sequence types of vancomycin-resistant Enterococcus faecium in a medical centre in Taiwan with recent increase in infections due to this microbial isolates and their implications

投稿摘要: Purpose
Despite being a normal inhabitant in human gastrointestinal tract, Enterococcus faecium is clinically progressively important, as increasing number of immunocompromised patients were reported to be involved in infections due to this microbe species. Vancomycin-resistant Enterococcus faecium (VRE-fm) is of particularly worrisome, which has been often found in in healthcare-infections and infection outbreaks in hospital setting worldwide. Previous studies demonstrated that sequence types (STs) 17 and 78 have been the epidemic strains causing VRE-fm infections in Taiwan since 2007. With recent increase in VRE-fm isolates found at Kaohsiung Chang Gung Memorial Hospital (KSCGMH), a medical centre in southern Taiwan, to clarify the implicated epidemic information, this study aimed to determine the STs of VREfm isolated from the hospital.

Methods
The Enterococcus faecium isolates were identified by conventional methods and MALDI-TOF (MALDI Biotyper System Microflex LT; Bruker Daltonik GmbH, Bremen, Germany). MIC values of vancomycin were determined using Phoenix 100 BD automated system (Becton Dickinson Diagnostic Systems, USA). Clonal relationship between strains was determined by pulsed-field gel electrophoresis (PFGE). Sequence analysis was performed using multilocus sequence typing (MLST) of each pulsotype and subtype.

Results
Of a total of 101 VRE-fm isolates collected between November 2016 and March 2019, 55% (n=56) were from ascites, 34% (n=34) from blood, 5% (n=5) from stool, 3% (n=3) from urine, and 3% (n=3) from pleural effusions; 72 unique PFGE types (Figure) and 14 sequence types (STs) were identified (Table). ST17 (46%) and the ST78 (37%) were the predominant sequence types.

Conclusions
Given the previously reported epidemiology information, our data suggested that VRE-fm of ST17 (46%) and ST78 (37%) has been around for more than a decade in Taiwan, involving multiple pulsotypes.

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