Low prevalence of VRE gastrointestinal colonization: RESULTS
The number of stool specimens evaluated in the first two weeks of each eight week period between January 1 and December 31,1997 ranged from 187 to 265. A total of 1408 stool specimens were tested. Sixty-seven of the 1408 (4.8%) hospitalized patients evaluated had VRE colonization of their lower GIT. Three of the 67 (4.5%) VRE identified were E faecium, while the remaining 64 isolates (95.5%) were Enterococcus gallinarum. Three of 1408 (0.2%) patients hospitalized in Manitoba, who had a stool specimen submitted for C difficile testing during the study period, were colonized with VREF. One isolate of VREF was identified at the Misericordia General Hospital, a Winnipeg community hospital, between April 23 and May 7, 1997. The two remaining isolates of VREF were identified between June 18 and July 2, 1997 at the Health Sciences Centre, a Winnipeg tertiary care hospital.
TABLE 1 Phenotypic and genotypic characteristics of the three vancomycin-resistant Enterococcus faecium (VREF) isolates identified as colonizers of the lower gastrointestinal tract of patients in Manitoba hospitals between January and December 1997
|
VREF isolate |
PCR profile |
PFGE profile |
V |
T |
A |
MICS fog/mL) S G |
C |
Q/D |
LY |
|
|
1* |
vanA |
1 |
128 |
32 |
64 |
>4000 |
>2000 |
>32 |
0.125 |
1 |
|
21 |
vanA |
2 |
256 |
32 |
64 |
>4000 |
>2000 |
>32 |
0.125 |
0.5 |
|
3f |
vanA |
2 |
256 |
32 |
64 |
>4000 |
>2000 |
>32 |
0.125 |
0.5 |
All three VREF identified possessed the vanA genotype (Table 1). The two isolates of VREF, from the Health Sciences Centre, possessed the same PFGE pattern while the third isolate, collected from a patient at the Misericordia General Hospital, had a different PFGE pattern (Table 1). Both PFGE patterns have been previously identified in VREF isolated in Manitoba (unpublished data), suggesting they may have been acquired locally or nosocomially. Using NCCLS serum breakpoints, the three isolates of VREF demonstrated uniform resistance to teicoplanin, ampicillin, streptomycin, gentamicin, and cipro- floxacin, but were sensitive to quinuprisitin/dalfopristin and LY333328 (Table 1).
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