Ecological replacement of Enterococcus faecalis by multiresistant clonal complex 17 Enterococcus faecium.
The proportion of enterococcal infections caused by ampicillin-resistant Enterococcus faecium (AREfm) in a European hospital increased from 2% in 1994 to 32% in 2005, with prevalence rates of AREfm endemicity of up to 35% in at least six hospital wards. Diabetes mellitus, three or more admissions in the preceding year, and use of beta-lactams and fluoroquinolones, were all associated with AREfm colonisation. Of 217 AREfm isolates that were genotyped, 97% belonged to clonal complex 17 (CC17). This ecological change mimics events preceding the emergence of vancomycin-resistant E. faecium (VREF) in the USA and may presage the emergence of CC17 VREF in European hospitals.
Top
J
J
Eijkman-Winkler Institute for Microbiology, Infectious Diseases and Inflammation, University Medical Centre Utrecht, Utrecht, The Netherlands. j.top@umcutrecht.nl
Willems
R
R
Blok
H
H
de Regt
M
M
Jalink
K
K
Troelstra
A
A
Goorhuis
B
B
Bonten
M
M
D000668:Ampicillin Resistance; D024901:Drug Resistance, Multiple, Bacterial; D004463:Ecology; D013293:Enterococcus faecalis / Q000187:drug effects* / Q000235:genetics; D016984:Enterococcus faecium / Q000187:drug effects* / Q000235:genetics; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology*; D006801:Humans; D018598:Minisatellite Repeats; D020713:Vancomycin Resistance