MOLECULAR EPIDEMIOLOGY OF GLYCOPEPTIDE-RESISTANT ENTEROCOCCUS-FAECIUMON A RENAL UNIT

The clinical and molecular epidemiology of glycopeptide-resistant Ente rococcus faecium was investigated during an outbreak on a renal unit. Forty-nine patients were colonized or infected during a 15-month perio d. Sites of colonization included faeces, urine, intravenous (IV) cath eter tips and wound swabs. Ten patients had infections, which included five bacteraemias and three episodes of peritonitis. Pulsed-field gel electrophoresis of 43 patient isolates of glycopeptide-resistant E. f aecium identified seven strains during the first 7 months of the outbr eak. Three of these strains affected five or more patients. One strain accounted for 17/43 isolates. Isolates that were possibly related to another renal unit strain were cultured from patients at two other Man chester hospitals. These isolates were epidemiologically-related, and may represent a single Manchester epidemic strain. Of five patients wh o had multiple isolates of glycopeptide-resistant E. faecium, three ha d isolates representing a single strain and two were colonized or infe cted by more than one strain.