北部九州地域における VRE の分離例と linezolid に対する抗菌薬感受性  [in Japanese] Cases were isolated of VRE in the northern Kyushu and antibacterial activity of linezolid and other drugs against bacterial strains encoding vanA, vanB, vanC genotype  [in Japanese]

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Abstract

Vancomycin-resistant enterococci (VRE) は米国において治療への難治性から重症院内感染症の原因上菌として注目され, その増加は社会的に問題化している。一方, ヨーロッパ地域では院内感染によるVREの検出率は米国に比べ低いが, 家畜などに<I>vanA</I>遺伝上子群を保有する大きな感染源の存在が指摘されている。日本では1996年に東京, 京都でVREがはじめて分離され, その増加が懸念されていたが, VREの分離例に関する報告は現在においても少ない。そこで, 北部九州地域でVREの分離例について調査した結果, 4施設9名の患者より<I>Enterococcus faecalis vanA</I> 2株, <I>E. faecalis vanB</I> 3株, <I>Enterococcus faecium vanA</I> 4株, <I>E. faecium vanB</I> 1株の合計10株を分離した。また, 本症例菌株と<I>Enterococcus gallinarum</I>および<I>Enterococcus casselifzavus</I>の21株を対象にvancomycin, teicoplanin, rifampicin, ampicillin, linezolidに対する抗菌力を寒天平板希釈法で検討した結果, わが国で唯一VRE感染症に適応をもつlinezolidは<I>vanA, oanB, vanC-1, vanC-2/3</I>のいずれかを保有する菌株すべてに対しMICは≦2μg/mLであった。

Vancomycin-resistant enterococci (VRE) are considered to be major causative bacteria of severe nosocomial infections resistant to antimicrobial agents, and the increase in VRE infections is a great concern in us social welfare. Although fewer hospital-acquired VRE infections are detected in Europe than that in the USA, the existence of <I>vanA</I> group genes in the veterinary field is considered a potential infection source. In Japan, VRE were isolated for the first time in Tokyo and Kyoto, therefore increase of VRE were uneasiness. However, only a few VRE were isolated from clinical materials in institutions. In our recent investigation on VRE incidence in northern Kyushu, 10 strains of VRE including two <I>Enterococcus faecalis vanA</I>, 3 <I>E. faecalis vanB</I>, 4 <I>Enterococcus faecium vanA</I> and 1 <I>E. faecium vanB</I> strain were isolated from patients at 4 institutions. Among antimicrobial agents (vancomycin, teicoplanin, rifampicin, ampicillin, and linezolid) tested for their susceptibility using agar dilution method against 21 vancomycins-weakly susceptible to highly resistant enterococci with either <I>vanA, vanB, vanC-1</I>, or <I>van C-2/3</I> genotype, including the above 9 VRE strains, minimum inhibitory concentrations (MICs) of LZD against VRE strains were all determined to be ≤2μg/mL categorized as susceptible according to the NCCLS.

Journal

  • Japanese Journal of Chemotherapy

    Japanese Journal of Chemotherapy 50(4), 209-214, 2002-04-25

    Japanese Society of Chemotherapy

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