title: Persistence of a clone of glycopeptide-resistant Enterococcus faecalis among patients in an intensive care unit of a Greek hospital.
abstract: OBJECTIVE
  To investigate an outbreak of glycopeptide-resistant Enterococcus faecalis (GREF) in the intensive care unit (ICU) of 'G. Gennimatas' General Hospital, Athens, Greece.
  
  
  METHODS
  Between August 2000 and November 2001, 20 highly GREF isolates were recovered from severe infections of separate patients in the ICU. The isolates were tested by PCR, PFGE, mating experiments and plasmid analysis.
  
  
  RESULTS
  All isolates carried the vanA gene. Nineteen isolates fitted to one clone by macrorestriction analysis with four subclones being consecutively detected. Each subclone seemed to predominate for a specific time period. Additionally, four GREF isolates related to the ICU clone were recovered from other wards of the hospital.
  
  
  CONCLUSIONS
  Our findings indicate that a monoclonal GREF outbreak persisted for more than 1 year in a large Greek hospital. The rate of GREF isolation declined after the application of infection control measures.
authors.affiliation: Department of Medical Microbiology, University of Thessalia, Larissa. pournaras@med.uth.gr
authors.forename: Spyros
authors.initials: S
authors.lastname: Pournaras
authors.forename: Helen
authors.initials: H
authors.lastname: Malamou-Lada
authors.forename: Maria
authors.initials: M
authors.lastname: Maniati
authors.forename: Dimitra
authors.initials: D
authors.lastname: Mylona-Petropoulou
authors.forename: Helen
authors.initials: H
authors.lastname: Vagiakou-Voudris
authors.forename: Athanassios
authors.initials: A
authors.lastname: Tsakris
authors.forename: Antonios N
authors.initials: AN
authors.lastname: Maniatis
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D003428:Cross Infection / Q000382:microbiology*; D004269:DNA, Bacterial / Q000235:genetics; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D016521:Electrophoresis, Gel, Pulsed-Field; D013293:Enterococcus faecalis / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D005798:Genes, Bacterial / Q000235:genetics; D006020:Glycopeptides / Q000494:pharmacology*; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology*; D006115:Greece; D006801:Humans; D007362:Intensive Care Units; D008826:Microbial Sensitivity Tests; D016133:Polymerase Chain Reaction
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D006020:Glycopeptides