title: The emergence of glycopeptide-resistant Enterococcus faecium in a university hospital in southwestern Greece.
abstract: BACKGROUND
  Enterococci and especially glycopeptide-resistant strains (GRE) are widely distributed in the hospital environment, by acquiring resistance determinants and virulence factors.
  
  
  METHODS
  The study included 48 GRE isolated during a 1-year period from different inpatients in a tertiary hospital in southwestern Greece. Antibiotic susceptibility was determined by the Etest, and the presence of resistance and virulence genes was shown by PCR. Clonal types were identified by pulsed-field gel electrophoresis of SmaI DNA digests.
  
  
  RESULTS
  All GRE were multi-resistant of the VanA phenotype, verified by the detection of the gene by PCR. Two major clones were distributed in all hospital wards. The majority of the strains (46 of 48) harbored the esp gene, while 27 GRE expressed also the gelE and/or as genes.
  
  
  CONCLUSIONS
  The spread of two clones expressing the vanA gene and virulence factors were responsible for the emergence of GRE in the University Hospital of Patras.
authors.affiliation: Department of Microbiology, University of Patras School of Medicine, Patras, Greece.
authors.forename: F
authors.initials: F
authors.lastname: Kolonitsiou
authors.forename: V
authors.initials: V
authors.lastname: Mani
authors.forename: H
authors.initials: H
authors.lastname: Parikou
authors.forename: M
authors.initials: M
authors.lastname: Trakala
authors.forename: G
authors.initials: G
authors.lastname: Dimitracopoulos
authors.forename: I
authors.initials: I
authors.lastname: Spiliopoulou
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D003428:Cross Infection / Q000382:microbiology*; D004269:DNA, Bacterial / Q000235:genetics; D024881:Drug Resistance, Bacterial; D016984:Enterococcus faecium / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D005798:Genes, Bacterial / Q000187:drug effects; D005838:Genotype; D006020:Glycopeptides; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology*; D006115:Greece; D006785:Hospitals, University; D006801:Humans; D008826:Microbial Sensitivity Tests; D010641:Phenotype; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D006020:Glycopeptides