title: Investigation of vancomycin resistant Enterococcus faecium outbreak in neonatal intensive care unit.
abstract: Enterococci are one of the major agents of community-acquired and nosocomial infections. In this study we aimed to analyze the clonal relation of the vancomycin-resistant Enterococci outbreak seen at the Neonate Intensive Care Unit (NICU) of Uludag University Hospital. Vancomycin resistance gene was investigated in the Enterococcus faecium strains and pulsed field gel electrophoresis (PFGE) was used to investigate the genetic relation between outbreak strains. Enterococci grown in all patient samples were identified as Enterococcus faecium by BD Phoenix 100 (Becton Dickinson, USA). We found vanA resistance gene in all of the swab samples by Xpert VanA/B test on Cepheid (Cepheid, USA). PFGE band patterns revealed two different strains, of which the majority of them (22/24) had the same clonal origin. The common clonal origin was also isolated from rectal probes. Perianal swab culture positivity was evaluated as colonization but culture growth in two blood cultures, two urine cultures and one wound culture was evaluated as infection and treated with linezolid. All of the patients survived the outbreak. Besides the infection control precautions determining the genetic relation between outbreak strains which can be done in the microbiology laboratory is necessary to control an outbreak. PFGE is a reliable method in the microbiologic analysis of outbreaks. Molecular microbiologic analysis of outbreak strains will contribute to prove the epidemiologic and evolution of outbreaks.
authors: Department of Medical Microbiology, Uludağ University Faculty of Medicine Bursa, Turkey.
authors: Burcu Dalyan
authors: BD
authors: Cilo
authors: Department of Medical Microbiology, Uludağ University Faculty of Medicine Bursa, Turkey.
authors: Harun
authors: H
authors: Ağca
authors: Department of Medical Microbiology, Uludağ University Faculty of Medicine Bursa, Turkey.
authors: Kadir
authors: K
authors: Efe
authors: Department of Medical Microbiology, Uludağ University Faculty of Medicine Bursa, Turkey.
authors: Melda
authors: M
authors: Sınırtaş
authors: Division of Pediatric Infectious Diseases, Department of Pediatrics, Uludağ University Faculty of Medicine Bursa, Turkey.
authors: Solmaz
authors: S
authors: Çelebi
authors: Division of Neonatalogy, Department of Pediatrics, Uludağ University Faculty of Medicine Bursa, Turkey.
authors: Hilal
authors: H
authors: Özkan
authors: Division of Neonatalogy, Department of Pediatrics, Uludağ University Faculty of Medicine Bursa, Turkey.
authors: Nilgün
authors: N
authors: Köksal
authors: Division of Pediatric Infectious Diseases, Department of Pediatrics, Uludağ University Faculty of Medicine Bursa, Turkey.
authors: Mustafa
authors: M
authors: Hacımustafaoğlu
authors: Department of Medical Microbiology, Uludağ University Faculty of Medicine Bursa, Turkey.
authors: Cüneyt
authors: C
authors: Özakın
keywords: Enterococcus; PFGE; neonatal; outbreak