title: Prevalence and molecular epidemiology of glycopeptide-resistant enterococci in Belgian renal dialysis units.
abstract: The molecular epidemiology of glycopeptide-resistant enterococci (GRE) colonizing the intestinal tracts of Belgian renal dialysis patients was studied among 1318 patients of a population of 1800 dialysis patients from 29 dialysis centers. Of these, 185 patients (14.0%) were colonized with a VANA-positive GRE; GRE harboring the VANB gene were not detected. The majority of the VANA GRE (80.5%) were identified as Enterococcus faecium; 14.8% were identified as E. faecalis; and a limited number were identified as E. avium, E. casseliflavus, E. dispar, E. durans, or E. gallinarum. Genome analysis of 277 VANA-positive GRE by pulsed-field gel electrophoresis revealed a high genetic variability both within the different dialysis centers and within the patients' own GRE flora. No high-level gentamicin-resistant VANA-positive GRE were detected, and most strains remained susceptible to ampicillin. These findings do not support a hospital-driven endemicity of VANA-positive enterococcal isolates in Belgium.
authors.affiliation: Department of Microbiology, University Hospital Antwerp, Universitaire Instelling Antwerpen, Antwerp, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Descheemaeker
authors.forename: M
authors.initials: M
authors.lastname: Ieven
authors.forename: S
authors.initials: S
authors.lastname: Chapelle
authors.forename: C
authors.initials: C
authors.lastname: Lammens
authors.forename: M
authors.initials: M
authors.lastname: Hauchecorne
authors.forename: M
authors.initials: M
authors.lastname: Wijdooghe
authors.forename: P
authors.initials: P
authors.lastname: Vandamme
authors.forename: H
authors.initials: H
authors.lastname: Goossens
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins; D001530:Belgium; D019729:Carbon-Oxygen Ligases; D016983:Enterococcus / Q000187:drug effects*; D005798:Genes, Bacterial; D005839:Gentamicins / Q000494:pharmacology; D006020:Glycopeptides; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology*; D006801:Humans; D007422:Intestines / Q000382:microbiology*; D017720:Molecular Epidemiology; D006435:Renal Dialysis / Q000009:adverse effects*; D020713:Vancomycin Resistance
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D005839:Gentamicins; D006020:Glycopeptides; C071437:VanA ligase, Bacteria; C079913:VanB protein, Enterococcus; D019729:Carbon-Oxygen Ligases