[Determination of the nosocomial origin of vancomycin-resistance strains of Enterococcus isolated from stool of patients in a hematology department].
Patients severely neutropenic, when hospitalized, occasionally receive selective digestive decontamination, and the risk of vancomycin-resistant strain selection is a drawback since glycopeptide resistance is often associated with betalactam and aminoglycosid resistance. Bacterial translocation can lead to multiresistant bacterial sepsis. Eighteen Enterococcus faecium strains were collected from patients hospitalized in the leukemia unit of the Universitary Hospital of Lille (CHRU, Pr Bauters) between October 1992 and July 1997 and were studied. Nosocomial acquisition or endogenous origin were investigated to choose well-adapted prevention. All the vancomycin-resistant strains were shown by Polymerase Chain Reaction having the van A gene. The clonality of these strains was investigated by Pulsed-Field-Gel-Electrophoresis after Sma I restriction. Pulsotype analysis showed variable homology (52%-100%). Our results do not show evidence of patient-to-patient E. faecium transmission and suggest vancomycin-resistant strains were independently selected by antibiotic therapy from individual fecal flora. Except when epidemic events or happen, this strain isolation is more related to antibiotic prescription than misuse of isolation techniques.
Laboratoire de Bactériologie-Hygiène, Centre hospitalier Docteur Schaffner, Lens, France.
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Trivier
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Savage
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Bauters
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Husson
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Courcol
D000328:Adult; D003428:Cross Infection / Q000382:microbiology*; D004352:Drug Resistance, Microbial; D018432:Drug Resistance, Multiple; D016984:Enterococcus faecium / Q000145:classification / Q000302:isolation & purification; D005243:Feces / Q000382:microbiology; D005602:France; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology* / Q000635:transmission; D006757:Hospital Units; D006785:Hospitals, University; D006801:Humans; D007938:Leukemia / Q000150:complications*; D010802:Phylogeny; D014640:Vancomycin / Q000494:pharmacology*
D014640:Vancomycin
Recherche de l'origine nosocomiale des souches d'entérocoques vancomycine-résistantes isolées des selles de patients du service des maladies du sang.