title: Molecular epidemiology of glycopeptide-resistant Enterococcus faecium on a renal unit.
abstract: The clinical and molecular epidemiology of glycopeptide-resistant Enterococcus faecium was investigated during an outbreak on a renal unit. Forty-nine patients were colonized or infected during a 15-month period. Sites of colonization included faeces, urine, intravenous (IV) catheter tips and wound swabs. Ten patients had infections, which included five bacteraemias and three episodes of peritonitis. Pulsed-field gel electrophoresis of 43 patient isolates of glycopeptide-resistant E. faecium identified seven strains during the first 7 months of the outbreak. Three of these strains affected five or more patients. One strain accounted for 17/43 isolates. Isolates that were possibly related to another renal unit strain were cultured from patients at two other Manchester hospitals. These isolates were epidemiologically-related, and may represent a single Manchester epidemic strain. Of five patients who had multiple isolates of glycopeptide-resistant E. faecium, three had isolates representing a single strain and two were colonized or infected by more than one strain.
authors.affiliation: Public Health Laboratory, Withington Hospital, Manchester.
authors.forename: P R
authors.initials: PR
authors.lastname: Chadwick
authors.forename: A
authors.initials: A
authors.lastname: Fox
authors.forename: N
authors.initials: N
authors.lastname: Woodford
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents; D003428:Cross Infection / Q000382:microbiology*; D016172:DNA Fingerprinting; D004269:DNA, Bacterial / Q000235:genetics*; D004196:Disease Outbreaks; D004352:Drug Resistance, Microbial; D004739:England; D016984:Enterococcus faecium / Q000145:classification / Q000235:genetics*; D005260:Female; D006020:Glycopeptides; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology*; D006436:Hemodialysis Units, Hospital; D006757:Hospital Units; D006801:Humans; D017053:Infection Control; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D006020:Glycopeptides