title: [Vancomycin-resistant enterococcus--chronicle of a foretold problem].
abstract: There have recently been 12 outbreaks of infection caused by vancomycin-resistant enterococci (VRE) in Dutch hospitals. Although the first VRE outbreaks were reported almost 12 years ago, such outbreaks remained uncommon and the question is why they are occurring now. Based on molecular epidemiological studies we have learned that a subpopulation of Enterococcus faecium, resistant to amoxicillin but susceptible to vancomycin, has become highly endemic in Dutch hospitals in the past 12 years. Initial analyses suggest that several transposons containing vancomycin-resistance genes have been introduced into this population, followed by nosocomial spread. We recommend that hospitals without detected VRE outbreaks screen high-risk patients for the presence of VRE. If transmission has already occurred in many hospitals, it will be extremely difficult (and costly) to eradicate VRE.
authors.affiliation: Universitair Medisch Centrum Utrecht, afd. Medische Microbiologie, Utrecht, the Netherlands. mbonten@umcutrecht.nl
authors.forename: Marc J M
authors.initials: MJ
authors.lastname: Bonten
authors.forename: Rob J
authors.initials: RJ
authors.lastname: Willems
mesh_terms: D003428:Cross Infection; D004196:Disease Outbreaks / Q000517:prevention & control*; D016983:Enterococcus; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy* / Q000453:epidemiology; D006761:Hospitals; D006801:Humans; D017053:Infection Control; D009426:Netherlands / Q000453:epidemiology; D020713:Vancomycin Resistance