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Please use this identifier to cite or link to this item: http://hdl.handle.net/10087/9111

Title: Nosocomial infection caused by vancomycin-susceptible multidrug-resistant Enterococcus faecalis over a long period in a university hospital in Japan
Other Titles: バンコマイシン感受性多剤耐性腸球菌(エンテロコッカス・フェカーリス)による長期間の病院感染-群馬大学医学部附属病院における検討
Authors: 工藤, 通明
クドウ, ミチアキ
Keywords: Enterococcus faecalis
multidrug resistance
non-vancomycin-resistant enterococci
nosocomial infection
Issue Date: 6-Mar-2015
Publisher: 群馬大学医学部
Abstract: Compared with other developed countries, vancomycin-resistant enterococci (VRE) are not widespread in clinical environments in Japan. There have been no VRE outbreaks and only a few VRE strains have sporadically been isolated in our university hospital in Gunma, Japan. To examine the drug susceptibility of Enterococcus faecalis and nosocomial infection caused by non-VRE strains, a retrospective surveillance was conducted in our university hospital. Molecular epidemiological analyses were performed on 1711 E. faecalis clinical isolates collected in our hospital over a 6-year period [1998–2003]. Of these isolates, 1241 (72.5%) were antibiotic resistant and 881 (51.5%) were resistant to two or more drugs. The incidence of multidrug resistant E. faecalis (MDR-Ef) isolates in the intensive care unit increased after enlargement and restructuring of the hospital. The major group of MDR-Ef strains consisted of 209 isolates (12.2%) resistant to the five drug combination tetracycline/erythromycin/kanamycin/streptomycin/gentamicin. Pulsed-field gel electrophoresis analysis of the major MDR-Ef isolates showed that nosocomial infections have been caused by MDR-Ef over a long period (more than 3 years). Multilocus sequence typing showed that these strains were mainly grouped into ST16 (CC58) or ST64 (CC8). Mating experiments suggested that the drug resistances were encoded on two conjugative transposons (integrative conjugative elements), one encoded tetracycline-resistance and the other erythromycin/kanamycin/streptomycin/gentamicinresistance. To our knowledge, this is the first report of nosocomial infection caused by vancomycinsusceptible MDR-Ef strains over a long period in Japan.
Description: 学位記番号:医博乙1403
URI: http://hdl.handle.net/10087/9111
Academic Degrees and number: 12301乙第1403号
Degree-granting date: 2015-03-06
Degree name: 博士(医学)
Degree-granting institutions: 群馬大学
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