Cl. Pearce et al., Clonal diversity of vancomycin-resistant enterococci from an outbreak in atertiary care university hospital, AM J INFECT, 26(6), 1998, pp. 563-568
Background: Enterococci have become important nosocomial pathogens and now
account for approximately 12% of nosocomial infections. Enterococci can be
transferred from patient to patient and from health care personnel to patie
nt. We investigated the clonal diversity of vancomycin-resistant enterococc
i (VRE) causing an outbreak of infections and attempted to determine the pa
tterns of spread of these bacteria in a university hospital.
Methods: Ribotyping was used to examine the clonal diversity of 50 VRE isol
ates, including 23 from wounds, 14 from urine, 8 from blood, 3 from the rec
tum, 1 from drainage, and 1 from the cornea.
Results: Nine patients were infected with Enterococcus faecalis, 10 with En
terococcus faecium, 3 with both E faecalis and E faecium, and 1 with Entero
coccus avium. The results suggest that the sources of the VRE infections in
cluded endogenous strains and strains acquired by transmission from attendi
ng staff or from the environment. Three patients were infected by both noso
comial and endogenous strains.
Conclusions: These data suggest that the collection and analysis of several
isolates from repeated specimens is necessary to obtain a fuller understan
ding of the epidemiology and population structure of antibiotic-resistant e
nterococci.