Nosocomial infection with vancomycin-dependent enterococci.
We report three patients infected with unique strains of vancomycin-dependent enterococci. Two were first infected by genetically identical strains of vancomycin-resistant enterococci (VRE). All three patients had much greater exposure to vancomycin and third-generation cephalosporins than did two control groups (patients infected with VRE and hospitalized patients without enterococcal infections). While antimicrobial pressure promotes nosocomial colonization by VRE, prolonged exposure to vancomycin may foster the transition from vancomycin resistance to dependence.
University of Wisconsin Medical School, Madison, USA. mdcpat@nus.edu.sg
Paul A
PA
Tambyah
John A
JA
Marx
Dennis G
DG
Maki
D000900:Anti-Bacterial Agents; D003428:Cross Infection / Q000382:microbiology; D016983:Enterococcus / Q000187:drug effects*; D016908:Gram-Positive Bacterial Infections; D006801:Humans; D008826:Microbial Sensitivity Tests; D014640:Vancomycin / Q000378:metabolism* / Q000494:pharmacology
D000900:Anti-Bacterial Agents; D014640:Vancomycin