title: Emergence of vanA vancomycin-resistant Enterococcus faecium in a hospital in Porto Alegre, South Brazil.
abstract: BACKGROUND
  In Porto Alegre (South Brazil), since the first VRE isolation in 2000 until the middle of the last decade, the epidemiology of enterococcal infections presented the peculiarity that, as opposed to other regions of the country, almost all VRE were E. faecalis. The aim of this study was to investigate the microbiological and epidemiological characteristics of a VRE outbreak that occurred between August 2010 and September 2011 in Porto Alegre, South Brazil.
  
  
  METHODS
  Twenty-nine isolates from inpatients of Mãe de Deus Hospital that were identified and characterized for their susceptibility profile, vancomycin genotype, presence of esp gene, biofilm production, and clonal relationship were collected.  Patients' records were reviewed for clinical information.
  
  
  RESULTS
  All isolates were identified as vancomycin/ampicillin resistant E. faecium carrying the vanA gene. Almost all were susceptible to gentamicin and streptomycin. Most patients died and were associated with a hemodialysis unit stay. All but the first isolate were clustered in a main clone.
  
  
  CONCLUSIONS
  An important change in vancomycin-resistant enterococci was observed. Studies like this are necessary to monitor the dissemination of VRE, especially of some individual clones.
authors: Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil. mariahccr@gmail.com.
authors: Mariah
authors: M
authors: Resende
authors: Juliana
authors: J
authors: Caierão
authors: Juliana Gil
authors: JG
authors: Prates
authors: Gabriel Azambuja
authors: GA
authors: Narvaez
authors: Cícero Armídio Gomes
authors: CA
authors: Dias
authors: Pedro Alves
authors: PA
authors: d'Azevedo
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics*; D018441:Biofilms; D001938:Brazil / Q000453:epidemiology; D019729:Carbon-Oxygen Ligases / Q000235:genetics*; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology; D003430:Cross-Sectional Studies; D004196:Disease Outbreaks; D016984:Enterococcus faecium / Q000235:genetics* / Q000302:isolation & purification; D005838:Genotype; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology*; D006761:Hospitals; D006801:Humans; D008826:Microbial Sensitivity Tests; D014640:Vancomycin / Q000494:pharmacology; D020713:Vancomycin Resistance / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; C071437:VanA ligase, Bacteria; D014640:Vancomycin; D019729:Carbon-Oxygen Ligases