title: Substantially increased faecal carriage of vancomycin-resistant enterococci in a tertiary Greek hospital after a 4 year time interval.
abstract: OBJECTIVE
  In a tertiary Greek hospital with no documented vancomycin-resistant enterococci (VRE) infections, a cross-sectional study was conducted in order to determine the degree of VRE faecal carriage among adult patients hospitalized in high-risk units.
  
  
  METHODS
  Specimens for the surveillance were collected from separate patients in two periods (January-May 1999 and January-May 2003); 258 specimens were submitted during the first period and 149 during the second period.
  
  
  RESULTS
  Three patients (1.2%) were colonized with VRE during the first period, whereas 52 (34.9%) were colonized during the second period. Two VRE isolates of the first period were Enterococcus faecalis and one Enterococcus faecium, whereas those of the second period were E. faecium except for three E. faecalis and two Enterococcus gallinarum. All VRE isolates apart from the two E. gallinarum isolates were positive for the vanA gene. The 48 vancomycin-resistant E. faecium were classified into eight clonal types, one of those predominating with 29 isolates; the remaining included one to nine isolates. The five vancomycin-resistant E. faecalis formed four distinct clonal types.
  
  
  CONCLUSIONS
  The study reports a substantially higher prevalence of VRE carriage when the surveillance was repeated after a 4 year time interval. Urgent infection control measures are needed to prevent emergence of VRE outbreaks in our hospital setting.
authors.affiliation: Department of Microbiology, Hippokration University Hospital, Thessaloniki, Greece.
authors.forename: D
authors.initials: D
authors.lastname: Sofianou
authors.forename: S
authors.initials: S
authors.lastname: Pournaras
authors.forename: M
authors.initials: M
authors.lastname: Giosi
authors.forename: A
authors.initials: A
authors.lastname: Polyzou
authors.forename: A N
authors.initials: AN
authors.lastname: Maniatis
authors.forename: A
authors.initials: A
authors.lastname: Tsakris
mesh_terms: D001426:Bacterial Proteins / Q000235:genetics; D019729:Carbon-Oxygen Ligases / Q000235:genetics; D002353:Carrier State / Q000382:microbiology*; D003428:Cross Infection / Q000382:microbiology; D003430:Cross-Sectional Studies; D015257:DNA-Cytosine Methylases / Q000235:genetics; D003625:Data Collection; D016983:Enterococcus / Q000187:drug effects* / Q000235:genetics; D005243:Feces / Q000382:microbiology*; D005838:Genotype; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology*; D006115:Greece / Q000453:epidemiology; D006801:Humans; D010641:Phenotype; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013997:Time Factors; D020713:Vancomycin Resistance / Q000235:genetics*
chemical_list: D001426:Bacterial Proteins; C071437:VanA ligase, Bacteria; C079006:DNA modification methylase XcyI; D015257:DNA-Cytosine Methylases; D019729:Carbon-Oxygen Ligases