Epidemiology of glycopeptide-resistant enterococci colonizing high-risk patients in hospitals in Johannesburg, Republic of South Africa

Recent cases of infections caused by glycopeptide-resistant enterococci (GR E) have highlighted the emergence of these organisms in the Republic of Sou th Africa. During May 1998 we conducted a prevalence study in four hospital s in Johannesburg and obtained 184 rectal swabs from patients identified as being at high risk for GRE colonization. Twenty enterococcal isolates show ing various glycopeptide resistance genotypes mere recovered: 3 Enterococcu s faecium vanA isolates, 10 E. faecium vanB isolates, 6 E. gallinarum vanC1 isolates, and 1 E. avium vanA isolate. Macrorestriction analysis was used to demonstrate the clonal spread of GRE strains within hospitals. Evidence also demonstrated the likely persistence of the original E. faecium vanA is olate associated with the first confirmed death contributed to by GRE infec tion in South Africa in March 1997.