title: Epidemiology of glycopeptide-resistant enterococci colonizing high-risk patients in hospitals in Johannesburg, Republic of South Africa.
abstract: Recent cases of infections caused by glycopeptide-resistant enterococci (GRE) have highlighted the emergence of these organisms in the Republic of South Africa. During May 1998 we conducted a prevalence study in four hospitals in Johannesburg and obtained 184 rectal swabs from patients identified as being at high risk for GRE colonization. Twenty enterococcal isolates showing various glycopeptide resistance genotypes were recovered: 3 Enterococcus faecium vanA isolates, 10 E. faecium vanB isolates, 6 E. gallinarum vanC1 isolates, and 1 E. avium vanA isolate. Macrorestriction analysis was used to demonstrate the clonal spread of GRE strains within hospitals. Evidence also demonstrated the likely persistence of the original E. faecium vanA isolate associated with the first confirmed death contributed to by GRE infection in South Africa in March 1997.
authors.affiliation: Department of Clinical Microbiology and Infectious Diseases, University of the Witwatersrand, and the South African Institute for Medical Research, Johannesburg, Republic of South Africa.
authors.forename: A
authors.initials: A
authors.lastname: von Gottberg
authors.forename: W
authors.initials: W
authors.lastname: van Nierop
authors.forename: A
authors.initials: A
authors.lastname: Dusé
authors.forename: M
authors.initials: M
authors.lastname: Kassel
authors.forename: K
authors.initials: K
authors.lastname: McCarthy
authors.forename: A
authors.initials: A
authors.lastname: Brink
authors.forename: M
authors.initials: M
authors.lastname: Meyers
authors.forename: R
authors.initials: R
authors.lastname: Smego
authors.forename: H
authors.initials: H
authors.lastname: Koornhof
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D004352:Drug Resistance, Microbial; D016983:Enterococcus / Q000145:classification / Q000187:drug effects* / Q000235:genetics; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D006761:Hospitals; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology; D014640:Vancomycin / Q000494:pharmacology; D020713:Vancomycin Resistance / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin