[Clinical and epidemiologic analysis of intestinal tract colonization with vancomycin-resistant enterococci in an intensive care unit].
Intestinal tract colonization with vancomycin resistant enterococci (VRE) was studied during five months and 25 days. Out of 171 patients hospitalized in the intensive care unit, 124 (73%) were included in this study. Thirty five of them (28%) were recognized as colonized with VRE. VRE isolates (n = 35) were identified as Enterococcus faecium (n = 18), Enterococcus gallinarum (n = 16), and Enterococcus raffinosus (n = 1). All of them were resistant to vancomycin (MIC90 = 512 microg/ml) and to teicoplanin (MIC90 = 32 microg/ml), having the vanA gene. By means of molecular methods a high homology was found among E. faecium and E. gallinarum isolates, respectively, suggesting their spread as a kind of outbreak. No significant differences in age or sex were found among colonized and non-colonized patients (p > 0.05). On the other hand, the hospitalization time and the use of broad-spectrum antibiotics were associated with colonization. From this study we highlight the importance of enhancing all measures of control and prevention of hospital infections, carefully analyzing the empiric antimicrobial schemes, trying to reduce the hospital stage, and following the surveillance to evaluate the efficacy of such procedures.
Hospital Interzonal General de Agudos Evita, Rio de Janeiro 1910 (1824), Lanús, Provincia de Buenos Aires, Argentina. anatogneri66@hotmail.com
A M
AM
Togneri
A
A
Corso
J
J
González
H
H
Lopardo
L B
LB
Podestá
P
P
Gagetti
M
M
Pérez
V
V
Rodríguez
M
M
Rodríguez
L
L
Ríos
E
E
Dinerstein
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001118:Argentina; D015331:Cohort Studies; D015897:Comorbidity; D004269:DNA, Bacterial / Q000235:genetics; D024901:Drug Resistance, Multiple, Bacterial; D016983:Enterococcus / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D005260:Female; D005838:Genotype; D006801:Humans; D007362:Intensive Care Units; D007422:Intestines / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017334:Teicoplanin / Q000494:pharmacology; D014640:Vancomycin / Q000494:pharmacology; D020713:Vancomycin Resistance
D004269:DNA, Bacterial; D017334:Teicoplanin; D014640:Vancomycin