Isolation and Characterization of Glycopeptide-resistant Enterococci from Hospitalized Patients over a 30-month Period

Overview

Journal J Clin Microbiol

Specialty Microbiology

Date 2000 Jun 2

PMID 10834962

Citations 7

Authors

R R Nelson

K F McGregor

A R Brown

S G Amyes

H Young

Affiliations

Soon will be listed here.

Abstract

In February 1996, a Hospital Infection Control Practices Advisory Committee-style screening program was commenced to isolate and subsequently characterize glycopeptide-resistant enterococci (GRE) from patients at a hospital trust in Glasgow, Scotland. Over the next 30 months, GRE were isolated from 154 patients. GRE were isolated from patients in traditionally high-risk areas such as the renal unit and intensive care unit and also in areas considered to be lower risk, including medical wards and associated long-stay geriatric hospitals. The majority (90%) of isolates were Enterococcus faecium vanB. The remaining isolates consisted of seven E. faecalis (vanA), three E. gallinarum (vanC), and a further six E. faecium (five vanA, one both vanA and vanB) isolates. Analysis of SmaI-digested DNA by pulsed-field gel electrophoresis revealed that 34 of 40 (85%) VanB E. faecium isolates were identical or closely related, while 11 of 13 (85%) VanA GRE were distinct. High-level aminoglycoside resistance was seen in less than 8% of isolates. VanB E. faecium isolates were almost uniformly resistant to ampicillin and tetracycline. In this study, GRE have been isolated over a prolonged period from a broad range of patients. Glycopeptide resistance within the study hospital trust appeared to be mainly due to the clonal dissemination of a single strain of E. faecium VanB.

Citing Articles

Molecular Analysis of Vancomycin-Resistant Enterococci Isolated from Regional Hospitals in Trinidad and Tobago.

Akpaka P, Kissoon S, Jayaratne P Adv Med. 2016; 2016:8762691.

PMID: 27299153 PMC: 4889799. DOI: 10.1155/2016/8762691.

Genotyping of vancomycin resistant enterococci in arak hospitals.

Hoseini Zadeh A, Shojapour M, Nazari R, Akbari M, Sofian M, Abtahi H Jundishapur J Microbiol. 2015; 8(4):e16287.

PMID: 26034536 PMC: 4449860. DOI: 10.5812/jjm.8(4)2015.16287.

Evaluation of chromogenic media in detection of vancomycin resistant enterococci.

D V, S V, S T S, M K Y, S M J Clin Diagn Res. 2015; 8(11):DC25-7.

PMID: 25584221 PMC: 4290239. DOI: 10.7860/JCDR/2014/11105.5212.

Epidemiology and control of an outbreak of vancomycin-resistant enterococci in the intensive care units.

Yoon Y, Sim H, Kim J, Park D, Sohn J, Roh K Yonsei Med J. 2009; 50(5):637-43.

PMID: 19881966 PMC: 2768237. DOI: 10.3349/ymj.2009.50.5.637.

Does vancomycin prescribing intervention affect vancomycin-resistant enterococcus infection and colonization in hospitals? A systematic review.

de Bruin M, Riley L BMC Infect Dis. 2007; 7:24.

PMID: 17425800 PMC: 1863420. DOI: 10.1186/1471-2334-7-24.

References

Morrison D, Woodford N, Cookson B . Epidemic vancomycin-resistant Enterococcus faecium in the UK. Clin Microbiol Infect. 1995; 1(2):146-147. DOI: 10.1111/j.1469-0691.1995.tb00460.x. View

Gray J, Pedler S . Antibiotic-resistant enterococci. J Hosp Infect. 1992; 21(1):1-14. DOI: 10.1016/0195-6701(92)90149-g. View

. A guide to sensitivity testing. Report of the Working Party on Antibiotic Sensitivity Testing of the British Society for Antimicrobial Chemotherapy. J Antimicrob Chemother. 1991; 27 Suppl D:1-50. View

Murray B, Singh K, Heath J, Sharma B, Weinstock G . Comparison of genomic DNAs of different enterococcal isolates using restriction endonucleases with infrequent recognition sites. J Clin Microbiol. 1990; 28(9):2059-63. PMC: 268103. DOI: 10.1128/jcm.28.9.2059-2063.1990. View

Morrison D, Woodford N, Cookson B . Enterococci as emerging pathogens of humans. J Appl Microbiol. 2017; 83(S1):89S-99S. DOI: 10.1046/j.1365-2672.83.s1.10.x. View

Uttley A, Collins C, Naidoo J, George R . Vancomycin-resistant enterococci. Lancet. 1988; 1(8575-6):57-8. DOI: 10.1016/s0140-6736(88)91037-9. View

Leclercq R, DERLOT E, Duval J, Courvalin P . Plasmid-mediated resistance to vancomycin and teicoplanin in Enterococcus faecium. N Engl J Med. 1988; 319(3):157-61. DOI: 10.1056/NEJM198807213190307. View

Tenover F, Arbeit R, Goering R, Mickelsen P, Murray B, Persing D . Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol. 1995; 33(9):2233-9. PMC: 228385. DOI: 10.1128/jcm.33.9.2233-2239.1995. View

Edmond M, Ober J, Weinbaum D, Pfaller M, Hwang T, Sanford M . Vancomycin-resistant Enterococcus faecium bacteremia: risk factors for infection. Clin Infect Dis. 1995; 20(5):1126-33. DOI: 10.1093/clinids/20.5.1126. View

10.

Evers S, Courvalin P . Detection of glycopeptide resistance genotypes and identification to the species level of clinically relevant enterococci by PCR. J Clin Microbiol. 1995; 33(1):24-7. PMC: 227872. DOI: 10.1128/jcm.33.1.24-27.1995. View

11.

. Recommendations for preventing the spread of vancomycin resistance. Infect Control Hosp Epidemiol. 1995; 16(2):105-13. DOI: 10.1086/647066. View

12.

Boyce J, Opal S, Chow J, Zervos M, Sherman C, Romulo R . Outbreak of multidrug-resistant Enterococcus faecium with transferable vanB class vancomycin resistance. J Clin Microbiol. 1994; 32(5):1148-53. PMC: 263627. DOI: 10.1128/jcm.32.5.1148-1153.1994. View

13.

Clark N, Cooksey R, Hill B, Swenson J, Tenover F . Characterization of glycopeptide-resistant enterococci from U.S. hospitals. Antimicrob Agents Chemother. 1993; 37(11):2311-7. PMC: 192384. DOI: 10.1128/AAC.37.11.2311. View

14.

. Nosocomial enterococci resistant to vancomycin--United States, 1989-1993. MMWR Morb Mortal Wkly Rep. 1993; 42(30):597-9. View

15.

Jensen M, Webster J, Straus N . Rapid identification of bacteria on the basis of polymerase chain reaction-amplified ribosomal DNA spacer polymorphisms. Appl Environ Microbiol. 1993; 59(4):945-52. PMC: 202221. DOI: 10.1128/aem.59.4.945-952.1993. View

16.

Moreno F, Grota P, Crisp C, Magnon K, Melcher G, Jorgensen J . Clinical and molecular epidemiology of vancomycin-resistant Enterococcus faecium during its emergence in a city in southern Texas. Clin Infect Dis. 1995; 21(5):1234-7. DOI: 10.1093/clinids/21.5.1234. View

17.

Vandamme P, Vercauteren E, Lammens C, Pensart N, Ieven M, Pot B . Survey of enterococcal susceptibility patterns in Belgium. J Clin Microbiol. 1996; 34(10):2572-6. PMC: 229320. DOI: 10.1128/jcm.34.10.2572-2576.1996. View

18.

Fraise A . The treatment and control of vancomycin resistant enterococci. J Antimicrob Chemother. 1996; 38(5):753-6. DOI: 10.1093/jac/38.5.753. View

19.

Tyrrell G, Bethune R, Willey B, Low D . Species identification of enterococci via intergenic ribosomal PCR. J Clin Microbiol. 1997; 35(5):1054-60. PMC: 232702. DOI: 10.1128/jcm.35.5.1054-1060.1997. View

20.

Pegues D, Pegues C, Hibberd P, Ford D, Hooper D . Emergence and dissemination of a highly vancomycin-resistant vanA strain of Enterococcus faecium at a large teaching hospital. J Clin Microbiol. 1997; 35(6):1565-70. PMC: 229788. DOI: 10.1128/jcm.35.6.1565-1570.1997. View