2015-08-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/645310摘要：萬古黴素抗藥性腸球菌（vancomycin-resistant enterococci，VRE)為現今臨床重要的致病抗藥性 菌株之一。由於可用以治療VRE感染的抗生素十分有限，因此，如何避免VRE感染的發生，是十 分重要的課題。在過去的研究中，我們發現若有VRE移生，則後續發生VRE感染的機會會大幅增 加。然而，僅有一部分VRE移生的患者，會發生後續VRE的感染。但究竟由VRE移生，進展到 VRE感染的危險因子為何，目前仍未有很好的研究，也未有定論；如果能找到特殊的危險因子，將 有機會對具有特殊危險因子的病患，進行專一的介入處理，以預防VRE感染的發生。因此，本研究 將利用台大醫院對VRE的主動篩檢作業，長期追蹤VRE移生的患者（為期六個月）；並收集其相關 人口學、臨床、實驗室檢查資料與微生物特徵，利用統計分析，以釐清VRE移生進展到感染的危險 因子。本研究計晝將分為前半與後半，前半將回溯性收集由2013年1月是2014年12月間，主動篩 檢發現為VRE移生者的資料；後半則由2015年1月至2017年12月，前瞻性收集主動篩檢發現為 VRE移生者的資料。<br> Abstract: Vancomycin-resistant enterococci (VRE) has become an important drug-resistant pathogen recently. Because only limited treatment choice for VRE infection is available, preventing the development of VRE infection is an important clinical issue. Previous studies demonstrate that VRE colonization is a significant factor associated with subsequent VRE infection. However, only a certain portion of VRE colonizers develop clinical infection thereafter. The risk factors for developing infections caused by VRE among VRE colonizers remain unclear and only limited relevant researches are available. If such risk factors can be identified, specific interventions can be conducted to prevent development of VRE infection among VRE colonizers. The present project will use the results of active surveillance for VRE colonization at National Taiwan University Hospital, longitudinally follow VRE colonizers for six months to see whether VRE infections will happen or not, and collect the relevant demographic, clinical, laboratory, and microbiologic data (including drug susceptibilities, genetic analysis for vancomycin resistance, molecular typing, and analyses for virulent factors and antibacteriocin production) of the VRE colonizers for analyzing the risk factors for developing VRE infection among VRE colonizers. This study will be conducted with two parts. The first one will be a retrospective cohort study and the second will be a prospective study. For the retrospective cohort study, the period of patient enrollment will be Jan. 2013 to Dec. 2014. For the prospective study, the period of patient enrollment will be Jan. 2015 to Dec. 2017.萬古黴素抗藥性腸球菌移生感染分子分型vancomycin resistanceenterococcicolonizationinfectionmolecular typing