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Park, Yeon-Joon,Yu, Jin Kyung,Kim, Sang-Il,Lee, Kyungwon,Arakawa, Yoshichika Institute for Clinical Science] 2009 Annals of clinical and laboratory science Vol.39 No.1
<P>A new plasmid-mediated fluoroquinolone efflux pump gene, qepA, is known to be associated with the rmtB gene, which confers high-level resistance to aminoglycosides. We investigated the qepA gene in 573 AmpC-producing Enterobacteriaceae including one Citrobacter freundii known to harbor rmtB. Of them, two clonally unrelated E. aerogenes harbored qepA. Both isolates co-harbored rmtB, qnrS1, qepA, and bla(LAP-1) on an IncFI type plasmid. The qepA was flanked by two copies of IS26 containing ISCR3C, tnpA, tnpR, bla(TEM), and rmtB. The qnrS1 and bla(LAP-1) were located upstream of qepA. All the resistance determinants (qepA, qnrS1, rmtB, and bla(LAP-1)) were co-transferred to E. coli J53 by filter mating from both isolates. Although the prevalence of qepA is currently low, considering the presence of ISCR3C and the possibility of co-selection and co-transferability of plasmids, more active surveillance for these multi-drug resistant bacteria and prudent use of antimicrobials are needed.</P>
P-7 : Multi-Institutional Surveillance of VRE in a Prefecture of Japan
( Hideji Yanagisawa ),( Atsuko Tsutsui ),( Satowa Suzuki ),( Kunikazu Yamane ),( Toshifumi Konda ),( Yoshichika Arakawa ) 대한임상병리사협회 2009 임상미생물검사학회 발표자료집 Vol.2009 No.-
Objective: Since vancomycin-resistant enterococci (VRE) has a multi-resistance property to various antimicrobial agents, their spread among clinical settings would become a major public health concern in Japan. To grasp exact prevalence rate of VRE, a multi-institutional study was conducted in a Prefecture in which a large VRE outbreak was disclosed in a hospital. Study design: Invitation letters to the VRE surveillance study were sent to 90 hospitals within the Prefecture. Thirteen hospitals agreed to participate in the study. All the patients who were hospitalized on a Monday in the study period were involved in the screening of VRE with ethical agreement. One stool sample and 3 rectal swabs were obtained from each patient. VRE recovered from specimens were subjected to molecular epidemiological analyses. Results: Of the 3,572 patients eligible to participate in the study, specimens were collected from 1,318 patients. VRE was isolated from 14 (1.1%) patients and all isolates were identified as Enterococcus faecium. The 14 patients colonizing VRE were hospitalized in 3 of the 13 hospitals participated in this study. A multi-locus sequence typing revealed that the isolates mainly belonged to the sequence type (ST) 18. Summary: In this investigation, we examined the carriage rate of VRE in the 13 hospitals agreed to participate in the survey. Estimated VRE carriage was still very low (1.1%) in Japan and all the VRE isolated in this Prefecture were E. faecium, but they were susceptible to tecoplanin as found in the VRE isolated from imported chicken meats. Pulsed-field gel electrophoresis showed that the isolates recovered from 2 hospitals were closely related suggesting a local spread of an epidemic VRE clone in this area.