| Nosocomial outbreak of vancomycin-resistant Enterococcus faecium in a paediatric unit at a Turkish university hospital. | |
| | |
MedLine Citation:
|
PMID: 18319236 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Despite growing concern about vancomycin-resistant enterococci (VRE) as nosocomial pathogens, especially in the USA, they have been rarely isolated in Turkish hospitals. After initial description in 2001 of unrelated VRE isolates, we report now the molecular characterization of a nosocomial outbreak at the Akdeniz University Hospital, Antalya, Turkey. METHODS: VRE isolates were from either clinical or rectal swab specimens. Identification, susceptibility testing and molecular characterization were performed according to standard techniques. Virulence genes (encoding aggregation substance, gelatinase, cytolysin, enterococcal surface protein and hyaluronidase) were sought by PCR. RESULTS: Thirty-six VRE were isolated from 10 patients between June and October 2005 in the Department of Paediatrics. Six patients were only carriers, two had urinary tract infections and two had bloodstream infections. All isolates were Enterococcus faecium, of vanA genotype and belonged either to a main pulsotype (A) or to three minor pulsotypes (B, C and D). The epidemic strain A, found in eight patients, expressed high-level glycopeptide resistance (MIC of vancomycin 256 mg/L and MIC of teicoplanin 64 mg/L) and was of multilocus sequence typing sequence type (ST) 31, whereas the minor strain D, found in two patients, expressed heterogeneous glycopeptide resistance (MIC of vancomycin 8 to 256 mg/L) and was ST18. Strains B and C were only found in single patients either with strain A or alone. The two epidemic strains A and D were esp gene-positive. Their vanA genes were located on transposons similar to Tn1546, except for deletion of the transposition genes and the presence of IS1542, inserted upstream of the vanA operon, and IS1216, inserted at the 3' end of the vanX gene. VRE outbreak was contained by early identification and implementation of measures for patient isolation and of stringent hand and environmental disinfection policies. CONCLUSIONS: This work underlines the emergence in Turkey of epidemic VRE clones that belong to the clonal complex-17 (CC-17) and that are esp-positive. |
| | |
Authors:
|
Ayla Ergani-Ozcan; Thierry Naas; Betil Ozhak Baysan; Dilara Ogunc; Dilara Inan; Dilek Colak; Patrice Nordmann |
Related Documents
:
|
20154376 - Nanoconjugated vancomycin: new opportunities for the development of anti-vrsa agents. 10829266 - Antibiotics for gram-positive bacterial infections. vancomycin, teicoplanin, quinuprist... 11252326 - In-vitro activity of fosfomycin against vancomycin-resistant enterococci. 8654446 - Epidemiologic analysis of glycopeptide-resistant enterococcus strains in neutropenic pa... 15537306 - Modified mutation method for screening low citrinin-producing strains of monascus purpu... 16084766 - Current challenges in antimicrobial chemotherapy: the impact of extended-spectrum beta-... |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2008-03-04 |
Journal Detail:
|
Title: The Journal of antimicrobial chemotherapy Volume: 61 ISSN: 1460-2091 ISO Abbreviation: J. Antimicrob. Chemother. Publication Date: 2008 May |
Date Detail:
|
Created Date: 2008-04-08 Completed Date: 2008-06-10 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 7513617 Medline TA: J Antimicrob Chemother Country: England |
Other Details:
|
Languages: eng Pagination: 1033-9 Citation Subset: IM |
Affiliation:
|
Medical Microbiology Department, Akdeniz University School of Medicine, Antalya, Turkey. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Anti-Bacterial Agents / pharmacology* Child Child, Preschool Cross Infection / epidemiology, microbiology* Disease Outbreaks* Enterococcus faecium / drug effects* Female Gram-Positive Bacterial Infections / epidemiology, microbiology* Hospital Units Hospitals, University Humans Infant Infant, Newborn Male Turkey / epidemiology Vancomycin / pharmacology* Vancomycin Resistance* |
| Chemical | |
Reg. No./Substance:
|
0/Anti-Bacterial Agents; 1404-90-6/Vancomycin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Coronary stenosis treated by percutaneous angioplasty in a patient with dermatomyositis.
Next Document: Large-scale mRNA expression profiling in the common ice plant, Mesembryanthemum crystallinum, perfor...