Clonal dissemination of VanA-type glycopeptide-resistant Enterococcus faecalis between hospitals of two cities located 100 km apart

Autor: O.J. Bratfich, Maria Luiza Moretti, C. Levi, Raquel Silveira Bello Stucchi, E. Vormittag, Anna S. Levin, G. Duboc, D. Blum-Menezes
Rok vydání: 2004
Předmět:
Physiology
Immunology
Biophysics
Microbial Sensitivity Tests
medicine.disease_cause
Biochemistry
Polymerase Chain Reaction
Enterococcus faecalis
Microbiology
Disease Outbreaks
Nosocomial transmission
Bacterial Proteins
Vancomycin
medicine
Pulsed-field gel electrophoresis
Humans
Vancomycin-resistant Enterococcus
Tn1546
General Pharmacology
Toxicology and Pharmaceutics
lcsh:QH301-705.5
Carbon-Oxygen Ligases
Gram-Positive Bacterial Infections
lcsh:R5-920
Cross Infection
biology
Teicoplanin
business.industry
General Neuroscience
Outbreak
Vancomycin Resistance
Cell Biology
General Medicine
biochemical phenomena
metabolism
and nutrition
biology.organism_classification
São Paulo
Anti-Bacterial Agents
Enterococcus
lcsh:Biology (General)
business
lcsh:Medicine (General)
Brazil
medicine.drug
Enterococcus faecium
Zdroj: Brazilian Journal of Medical and Biological Research, Vol 37, Iss 9, Pp 1339-1343 (2004)
Brazilian Journal of Medical and Biological Research, Volume: 37, Issue: 9, Pages: 1339-1343, Published: SEP 2004
ISSN: 0100-879X
Popis: Nosocomial dissemination of glycopeptide-resistant enterococci represents a major problem in hospitals worldwide. In Brazil, the dissemination among hospitals in the city of São Paulo of polyclonal DNA profiles was previously described for vancomycin-resistant Enterococcus faecium. We describe here the dissemination of VanA phenotype E. faecalis between two hospitals located in different cities in the State of São Paulo. The index outbreak occurred in a tertiary care university hospital (HCUSP) in the city of São Paulo and three years later a cluster caused by the same strain was recognized in two patients hospitalized in a private tertiary care hospital (CMC) located 100 km away in the interior of the state. From May to July 1999, 10 strains of vancomycin-resistant E. faecalis were isolated from 10 patients hospitalized in the HCUSP. The DNA genotyping using pulsed-field gel electrophoresis (PFGE) showed that all isolates were originated from the same clone, suggesting nosocomial dissemination. From May to July 2002, three strains of vancomycin-resistant E. faecalis were isolated from two patients hospitalized in CMC and both patients were colonized by the vancomycin-resistant Enterococcus in skin lesions. All isolates from CMC and HCUSP were highly resistant to vancomycin and teicoplanin. The three strains from CMC had minimum inhibitory concentration256 micro g/ml for vancomycin, and 64 (CMC 1 and CMC 2) and 96 micro g/ml (CMC 3) for teicoplanin, characterizing a profile of VanA resistance to glycopeptides. All strains had the presence of the transposon Tn1546 detected by PCR and were closely related when typed by PFGE. The dissemination of the E. faecalis VanA phenotype among hospitals located in different cities is of great concern because E. faecalis commonly colonizes the gastrointestinal tract of patients and healthy persons for periods varying from weeks to years, which, together with the persistence of vancomycin-resistant Enterococcus in hospital rooms after standard cleaning procedures, increases the risk of the dissemination and reservoir of the bacteria.
Databáze: OpenAIRE
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