title: Acquisition of antibiotic-resistant Enterococcus faecium strains during long-term hospitalization and fast adaptation of enterococcal flora to antibiotic treatment: a case report.
abstract: Recently, it has been suspected that long durations of hospitalization might be a possible risk factor to get colonized by multiple VRE strains. Here we present the case of a patient who underwent stem cell transplantation and subsequently stayed at the hospital for about 4 months until death. At least four different Enterococcus faecium strains were identified from routinely taken microbiological specimens as demonstrated by pulsed-field gel-electrophoresis. Additionally, these strains showed variable susceptibility to quinupristine/dalfopristine, vancomycin, and/or linezolid depending on different antibiotic administrations. These findings indicate that patients might be colonized with multiple Enterococcus faecium strains and that the enterococcal flora quickly adapts due to antibiotic exposure.
authors.affiliation: Institute of Medical Microbiology and Hygiene, Eberhard-Karls-University, Tübingen, Germany.
authors.forename: Berit
authors.initials: B
authors.lastname: Schulte
authors.forename: Christiane
authors.initials: C
authors.lastname: Wolz
authors.forename: Ulrike
authors.initials: U
authors.lastname: Schumacher
authors.forename: Kurt
authors.initials: K
authors.lastname: Beyser
authors.forename: Peter
authors.initials: P
authors.lastname: Heeg
authors.forename: Stefan
authors.initials: S
authors.lastname: Borgmann
mesh_terms: D000220:Adaptation, Biological; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D005075:Biological Evolution; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D016984:Enterococcus faecium / Q000235:genetics* / Q000472:pathogenicity; D005260:Female; D006760:Hospitalization; D006801:Humans; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D020713:Vancomycin Resistance / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents