ChromID VRE agar를 사용한 반코마이신 내성 장구균 동정의 구분
Distribution of Vancomycin-resistant Enterococci Isolates Using a ChromID VRE Agar
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Vancomycin-resistant enterococci (VRE) have emerged as important healthcare-associated infection since last two decades. ChromID VRE agar (cIDVA) is useful for VRE rectal swab screening. We investigated all VRE were isolated on the cIDVA. A total of 363 rectal swabs of 85 patients to test VRE screening were inoculated into bile-esculin (B-E) broth with 6 μg/mL vancomycin. After 24 hours incubation, we subcultured B-E broths were changed to black onto cIDVA. All isolates were identified by the MICROSCAN and VITEK2. The vanA gene and vancomycin minimal inhibition concentration (MIC) were detected by PCR and E-test respectively. 277 E. faecium (84.7%), 16 E. faecalis (4.9%), 25 E. avium (7.6%), 8 E. gallinarum (2.4%) and 1 E. raffinosus (0.3%) were isolated. 10.3% of VRE detected on cIDVA were other than E. faecium and E. faecalis that presented various color from colorless to pale violet. All isolates contained vanA and vancomycin MIC were ＞256 μg/mL. VRE isolates other than E. faecium and E. faecalis should be objective to the contact precautions for healthcare-associated infection control if they possess vanA gene. Due to emerging enterococci carrying vanA such as E. avium, E. gallinarum, and E. raffinosus, VRE surveillance should be expanded to all isolates on chromogenic agar.
Abstract
Vancomycin-resistant enterococci (VRE) have emerged as important healthcare-associated infection since last two decades. ChromID VRE agar (cIDVA) is useful for VRE rectal swab screening. We investigated all VRE were isolated on the cIDVA. A total of 363 rectal swabs of 85 patients to test VRE screening were inoculated into bile-esculin (B-E) broth with 6 μg/mL vancomycin. After 24 hours incubation, we subcultured B-E broths were changed to black onto cIDVA. All isolates were identified by the MICROSCAN and VITEK2. The vanA gene and vancomycin minimal inhibition concentration (MIC) were detected by PCR and E-test respectively. 277 E. faecium (84.7%), 16 E. faecalis (4.9%), 25 E. avium (7.6%), 8 E. gallinarum (2.4%) and 1 E. raffinosus (0.3%) were isolated. 10.3% of VRE detected on cIDVA were other than E. faecium and E. faecalis that presented various color from colorless to pale violet. All isolates contained vanA and vancomycin MIC were ＞256 μg/mL. VRE isolates other than E. faecium and E. faecalis should be objective to the contact precautions for healthcare-associated infection control if they possess vanA gene. Due to emerging enterococci carrying vanA such as E. avium, E. gallinarum, and E. raffinosus, VRE surveillance should be expanded to all isolates on chromogenic agar.
참고문헌 (12)
- Berktas M, "vanC gene-related intrinsic teicoplanin resistance detected in Enterococcus casseliflavus and E. gallinarumstrains by the BD phoenix automated microbiology system", J Clin Microbiol, 46, pp.2466~2075 (2008)
- Cetinkaya Y, "Vancomycin-resistant enterococci", J Clin Microbiol Rev, 13, pp.686~707 (2000)
- 차충환, "Detection of Vancomycin-resistant Enterococci using Multiplex Real-time PCR Assay and Melting Curve Analysis", Annals of Laboratory Medicine, 30(2), pp.138~146 (2010), 대한진단검사의학회
- Cuzon G, "Novel chromogenic medium for detection of vancomycin-resistant Enterococcus faecium and Enterococcus faecalis", J Clin Microbiol, 46, pp.2442~2444 (2008)
- Delmas J, "Evaluation of a new chromogenic medium, ChromID VRE, for detection of vancomycin- resistant enterococci in stool samples and rectal swabs", J Clin Microbiol, 45, pp.2731~2733 (2007)
- Dutka-Malen S, "Emergence of high-level resistance to glycopeptides in Enterococcus gallinarum and Enterococcus casseliflavus", Antimicrob Agents Chemother, 38, pp.1675~1677 (1994)
- Harbarth S, "Effects of antibiotics on nosocomial epidemiology of vancomycin-resistant Enterococci", Antimicrob Agents Chemother, 46, pp.1619~1628 (2002)
- Kallstrom G, "Evaluation of a chromogenic agar under development to screen for VRE colonization", J Clin Microbiol, 48, pp.999~1001 (2010)
- 김도훈, "Evaluation of the Usefulness of Selective Chromogenic Agar Medium (ChromID VRE) and Multiplex PCR Method for the Detection of Vancomycin-resistant Enterococci", Annals of Laboratory Medicine, 30(6), pp.631~636 (2010), 대한진단검사의학회
- 이희주, "2003∼2007년 한 대학병원 혈액배양에서 분리된 장알균의 항균제 저항성 및 Vancomycin 내성 장알균 균혈증에 관여하는 위험인자 분석", Annals of Clinical Microbiology, 13(2), pp.59~67 (2010), 대한임상미생물학회
- Peterson JF, "Evaluation of Spectra VRE, a new chromogenic agar medium designed to screen for vancomycin-resistant Enterococcus faecalis and Enterococcus faecium", J Clin Microbiol, 48, pp.4627~4629 (2010)
- Joon Young Song, "Prevalence and Molecular Epidemiology of Vancomycin-Resistant Enterococci (VRE) Strains Isolated from Animals and Humans in Korea", The Korean Journal of Internal Medicine, 20(1), pp.55~62 (2005), 대한내과학회