Molecular Epidemiology and Surveillence of Vancomycin-resistant Enterococci at Seoul National University Hospital.
- Author:
Sun Hee LEE
1
;
Sang Won PARK
;
Hong Bin KIM
;
Ui Seok KIM
;
Thoma KIM
;
Hyang Soon OH
;
Myoung Don OH
;
Eui Chog KIM
;
Kang Won CHOE
Author Information
1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Vancomycin-resistant enterococcus;
Ep-idemiology;
Pulsed-field gel electrophoresis;
Polymerase chain reaction
- MeSH:
Ampicillin;
Anti-Bacterial Agents;
Ciprofloxacin;
Colon;
Electrophoresis, Gel, Pulsed-Field;
Epidemiology;
Genotype;
Gentamicins;
Humans;
Imipenem;
Intensive Care Units;
Medical Records;
Molecular Epidemiology*;
Polymerase Chain Reaction;
Rifampin;
Seoul*;
Streptomycin;
Teicoplanin;
Tetracycline;
Vancomycin
- From:Korean Journal of Infectious Diseases
2000;32(4):315-324
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The purpose of this study is to investigate the epidemiology and microbiological susceptibility patterns of vancomycin-resistant enterococci (VRE) in Seoul National University Hospital. METHODS: The VRE isolates between May 1998 and October 1999 were studied. We reviewed the medical records of VRE-isolated patients for clinical and epidemiologic data. The susceptibility of VRE to ampicillin, vancomycin, teicoplanin, gentamicin, streptomycin, ciprofloxacin, imipenem, rifampin, tetracyclin were determined by micro-dilution method. PCR for genotyping and PFGE for molecular epidemiology were performed. RESULTS: Twenty-nine VRE isolates were identified from 14 patients, 12 patients from clinical specimens and two from only rectal surveillence cultures. All strains were E. faecium and expressed vanA genotype. The vancomycin MIC and teicoplanin MIC were >128microgram/mL for all isolates. All isolates also resistant to most other antibiotics tested (ampicillin 84.2%, gentamicin 73.7%, streptomycin 73.7%, ciprofloxacin 84.2%, tetracycline 63.2%, rifampin 84.2%, imipenem 94.7%). PFGE analysis revealed 17 distinct PFGE strain types from 14 patients and there were no predominent types. Two patterns, each of them represented by two isolates, were identical. One of which was not associated epidemiologically but the other was associated with direct spread from colonized patient at the intensive care unit. CONCLUSION: The majority of VRE cases occurring at Seoul National University Hospital were not caused by epidemiologic strains but sporadic isolations although there was one case of patient to patient spread.
