title: Emergence of vancomycin-resistant enterococci in a tertiary hospital in Crete, Greece: a cluster of cases and prevalence study on intestinal colonisation.
abstract: The aim of this study was to investigate the clinical and epidemiological characteristics of five consecutive cases of infection with vancomycin-resistant enterococci (VRE) and the prevalence of faecal carriage of VRE among patients admitted to a 700-bed university hospital where no VRE had been isolated previously. In a 2-month period, five consecutive patients infected with VRE were detected. Three VanB+ Enterococcus faecium isolates were obtained from three patients, while two VanA+ E. faecium isolates, one VanA+ Enterococcus faecalis isolate and one VanC1+ Enterococcus gallinarum isolate were obtained from the other two patients. Of 218 faecal specimens from all hospital wards, 41 (18.8%) were found to contain VRE. Forty-two isolates of VRE were obtained, comprising one (2%) E. faecalis, 11 (27%) E. faecium, 24 (57%) E. gallinarum and six (14%) Enterococcus casseliflavus/flavescens. Four isolates carried the vanA gene, eight carried vanB, 24 carried vanC1, and six carried vanC2/C3. Use of glycopeptides, the presence of central venous catheters and renal dialysis all correlated with VRE colonisation. The prevalence rates were among the highest reported in the literature.
authors.affiliation: Department of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine, University Hospital of Heraklion, Crete, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Christidou
authors.forename: A
authors.initials: A
authors.lastname: Gikas
authors.forename: E
authors.initials: E
authors.lastname: Scoulica
authors.forename: J
authors.initials: J
authors.lastname: Pediaditis
authors.forename: M
authors.initials: M
authors.lastname: Roumbelaki
authors.forename: A
authors.initials: A
authors.lastname: Georgiladakis
authors.forename: Y
authors.initials: Y
authors.lastname: Tselentis
mesh_terms: D000328:Adult; D000368:Aged; D001426:Bacterial Proteins / Q000235:genetics; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology; D021821:Communicable Diseases, Emerging / Q000453:epidemiology / Q000382:microbiology; D016983:Enterococcus / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D013293:Enterococcus faecalis / Q000187:drug effects; D016984:Enterococcus faecium / Q000187:drug effects; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology / Q000382:microbiology; D006115:Greece / Q000453:epidemiology; D006761:Hospitals; D006801:Humans; D007422:Intestines / Q000382:microbiology*; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D015995:Prevalence; D020713:Vancomycin Resistance / Q000235:genetics*
chemical_list: D001426:Bacterial Proteins