title: Frequent transmission of enterococcal strains between mechanically ventilated patients treated at an intensive care unit.
abstract: The objectives of this investigation were to study the respiratory tract colonization and transmission of enterococci between 20 patients treated with mechanical ventilation at an intensive care unit (ICU), to compare genotyping with phenotyping, and to determine the antibiotic susceptibilities of the isolated enterococci. Samples were collected from the oropharynx, stomach, subglottic space, and trachea within 24 h of intubation, every third day until day 18, and thereafter every fifth day until day 33. Enterococcal isolates (n = 170) were analyzed by pulsed-field gel electrophoresis and with the PhenePlate (PhP) system. The antimicrobial susceptibilities to five agents were determined. Seventeen of the 20 subjects were colonized with enterococci in the respiratory tract; 12 were colonized in the lower respiratory tract. Genotype analyses suggested that 13 patients were involved in a transmission event, including all patients intubated more than 12 days. In conclusion, colonization of resistant enterococci in the respiratory tract of intubated patients treated at an ICU was common. Transmission of enterococci between patients occurred frequently. Prolonged intubation period seems to be a risk factor for enterococcal cross-transmission.
authors.affiliation: Division of Clinical Bacteriology, Huddinge University Hospital, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Bodil
authors.initials: B
authors.lastname: Lund
authors.forename: Christina
authors.initials: C
authors.lastname: Agvald-Ohman
authors.forename: Anna
authors.initials: A
authors.lastname: Hultberg
authors.forename: Charlotta
authors.initials: C
authors.lastname: Edlund
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D015373:Bacterial Typing Techniques / Q000379:methods; D024881:Drug Resistance, Bacterial; D013293:Enterococcus faecalis / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification / Q000378:metabolism; D005838:Genotype; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology / Q000635:transmission*; D006801:Humans; D007362:Intensive Care Units; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010641:Phenotype; D012137:Respiratory System / Q000382:microbiology; D012122:Ventilators, Mechanical
chemical_list: D000900:Anti-Bacterial Agents