title: The prevalence and clonal expansion of high-level gentamicin-resistant enterococci isolated from blood cultures in a Dutch university hospital.
abstract: We studied the prevalence and clonality of high-level gentamicin-resistant enterococci (HLGRE) in a Dutch university hospital. Of 238 enterococcal strains isolated from blood cultures between 1991 and 1997, 57 were HLGRE. Genomic analysis of these strains revealed 19 different genotypes, two of which were encountered more frequently [type A (12/57), type B (23/57)]. The spread of these types largely explained the rise in HLGRE incidence from 14% in 1991 to 31% in 1997. However, the contribution of unique strains to the total HLGRE burden also increased from 4% to 16%. We conclude that both clonal expansion and the emergence of unique HLGRE have contributed significantly to the increasing incidence of HLGRE.
authors.affiliation: Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands. vandenbraak@bacl.azr.nl
authors.forename: N
authors.initials: N
authors.lastname: van Den Braak
authors.forename: A
authors.initials: A
authors.lastname: van Belkum
authors.forename: D
authors.initials: D
authors.lastname: Kreft
authors.forename: R
authors.initials: R
authors.lastname: te Witt
authors.forename: H A
authors.initials: HA
authors.lastname: Verbrugh
authors.forename: H P
authors.initials: HP
authors.lastname: Endtz
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology; D001769:Blood / Q000382:microbiology; D003470:Culture Media; D004269:DNA, Bacterial / Q000032:analysis; D004352:Drug Resistance, Microbial / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D016983:Enterococcus / Q000187:drug effects* / Q000235:genetics* / Q000302:isolation & purification; D005839:Gentamicins / Q000494:pharmacology*; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology*; D006785:Hospitals, University; D006801:Humans; D008826:Microbial Sensitivity Tests; D009426:Netherlands / Q000453:epidemiology; D016133:Polymerase Chain Reaction / Q000379:methods; D015995:Prevalence
chemical_list: D000900:Anti-Bacterial Agents; D003470:Culture Media; D004269:DNA, Bacterial; D005839:Gentamicins