EPIDEMIOLOGIC ANALYSIS OF GLYCOPEPTIDE-RESISTANT ENTEROCOCCUS STRAINSIN NEUTROPENIC PATIENTS RECEIVING PROLONGED VANCOMYCIN ADMINISTRATION

Vancomycin-resistant enterococci have been isolated with increasing fr equency since 1988. Thus far, most of these resistant enterococci have belonged to the Enterococcus faecium species, and epidemiological stu dies have shown a wide diversity among interhospital and intrahospital isolates. This report presents an epidemiologic investigation of 25 v ancomycin-resistant Enterococcus strains - 24 Enterococcus faecium and one Enterococcus gallinarum - isolated from the stools or blood of ad ult patients receiving intravenous vancomycin prophylaxis during neutr openia and hospitalized in a single hematologic unit. Macrorestriction patterns of total DNA and of ribosomal DNA regions were used to analy ze the strains, Strains produced different total DNA restriction fragm ent length polymorphism patterns after Smal digestion, Ribotyping was less discriminative than pulsed-field gel electrophoresis. The results confirmed the genetic unrelatedness of the strains, Prolonged vancomy cin administration, commonly used in hematologic units, could be invol ved in the selection of endogenous resistant enterococcal strains.