Τίτλος:
Colonisation with vancomycin- and linezolid-resistant Enterococcus
faecium in a university hospital: molecular epidemiology and risk factor
analysis
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
During a hospital-wide prospective point prevalence survey of faecal
carriage and environmental colonisation of vancomycin-resistant
enterococci in a tertiary care university hospital in Athens (Greece),
five clinical and one environmental isolate from a light switch (all in
the haematology ward) were identified as vancomycin- and
linezolid-resistant vanA-positive Enterococcus faecium (VLRE). The
studied isolates exhibited a linezolid minimum inhibitory concentration
of 12 mu g/mL and carried at least one mutated copy of the 23S rRNA
gene, as shown by polymerase chain reaction-restriction fragment length
polymorphism (PCR-RFLP) analysis to detect the G2576T mutation. The
enterococcal surface protein (esp) gene was detected by PCR in all
isolates. Molecular typing with pulsed field gel electrophoresis (PFGE)
showed that the environmental and four of the five clinical isolates
were genetically related. None of the colonised patients were previously
exposed to linezolid, although heavy linezolid use was noted in the
institution. A case-control study was performed to assess risk factors
for VLRE colonisation. In univariate analysis, immunodeficiency,
underlying haematological malignancy, duration of any antimicrobial
treatment before VLRE isolation, and hospitalisation in the haematology
ward were pointed out as possible risk factors. A multidisciplinary
approach including intensified hand hygiene, patient contact isolation,
disinfection of the inanimate environment and antibiotic restriction
resulted in early containment of the VLRE colonisation outbreak. (C)
2008 Elsevier B. V. and the International Society of Chemotherapy. All
rights reserved.
Συγγραφείς:
Souli, Maria
Sakka, Vissaria
Galani, Irene
Antoniadou,
Anastasia
Galani, Lambrini
Siafakas, Nikolaos
Zerva, Loukia
and Fytrou, Helen
Tsiodras, Sotirios
Giamarellou, Helen
Περιοδικό:
International Journal of Antimicrobial Agents
Λέξεις-κλειδιά:
Antimicrobial resistance; VRE; Esp; Environmental contamination
DOI:
10.1016/j.ijantimicag.2008.08.017
