FECAL CARRIAGE OF VANCOMYCIN-RESISTANT ENTEROCOCCI IN HOSPITALIZED-PATIENTS AND THOSE LIVING IN THE COMMUNITY IN THE NETHERLANDS

In order to determine the prevalence of vancomycin-resistant enterococ ci (VRE) in The Netherlands, 624 hospitalized patients from intensive care units or hemato-oncology wards in nine hospitals and 200 patients living in the community were screened for VRE colonization. Enterococ ci were found in 49% of the hospitalized patients and in 80% of the pa tients living in the community, Of these strains, 43 and 32%, respecti vely, were Enterococcus faecium. VRE were isolated from 12 of 624 (2%) and 4 of 200 (2%) hospitalized patients and patients living in the co mmunity, respectively. PCR analysis of these 16 strains and 11 additio nal clinical VRE isolates from one of the participating hospitals reve aled 24 vanA gene-containing, 1 vanB gene-containing, and 2 vanC1 gene -containing strains. All strains were cross-resistant to avoparcin but were sensitive to the novel glycopeptide antibiotic LY333328. Genotyp ing of the strains by arbitrarily primed PCR and pulsed-field gel elec trophoresis revealed a high degree of genetic heterogeneity, This unun derscores a lack of hospital-driven endemicity of VRE clones. It is su ggested that the VRE in hospitalized patients have originated from unk nown sources in the community.