EPIDEMIOLOGY AND CONTROL OF VANCOMYCIN-RESISTANT ENTEROCOCCI (VRE) INA RENAL UNIT

This study reports an outbreak of infection and colonization caused by vancomycin-resistant enterococci (VRE) in the renal service of a larg e teaching hospital. The polymerase chain reaction and pulsed-field ge l electrophoresis were used to study the epidemiology of 26/34 strains of vancomycin-resistant Enterococcus faecalis and Enterococcus faeciu m from the outbreak in comparison with five strains from other hospita ls in Edinburgh and the Borders, and three from other wards in the Roy al Infirmary. The study revealed a heterogeneous population of vancomy cin-resistant E. faecalis. Over 60% of E. faecium isolates had matchin g pulsed-field gel electrophoresis patterns and all of these were of V anA phenotype. These results suggest that clonal spread of VanA phenot ype E. faecium within and possibly between hospitals is the major vanc omycin-resistant enterococcal problem in Edinburgh. Screening of patie nts and isolation of colonized and infected patients appear to have be en successful in controlling the spread of VRE.