Recovery of high-level streptomycin-resistant enterococci from hemodialysis water and dialysate in 85 Greek renal units

In the 85 renal units of Greece, enterococci were recovered from 10 samples of tap water, 6 of treated hemodialysis water, and 21 of dialysate. Eleven isolates were Enterococcus faecium, and 8 were Enterococcus raffinosus; 6 other additional enterococcal species were found. Twenty-two strains exhibi ted high-level resistance to streptomycin, 16 were resistant to rifampicin, and one to erythromycin. In our hemodialysis units, treated water and dial ysate raise concern regarding transfer to patients of uncommon enterococcal species exhibiting high-level streptomycin resistance (Infect Control Hosp Epidemiol 1999;20:686-689).