Nosocomial cross transmission as a primary cause of vancomycin-resistant enterococci in Austria

Stool specimens from 226 patients from intensive care units (N = 69), gener al wards (N = 112), and outpatient-clinics (N = 45) at the Innsbruck Univer sity Hospital and from 433 healthy volunteers were inoculated on to Enteroc occosel Agar supplemented with 50 mu g/mL vancomycin and LC mu g/mL cefodiz ime. Faecal specimens from 105 dairy cows, 171 pigs and 47 egg-laying hens were processed the same way Thirteen of 226 patients (5.8%) harboured 14 va ncomycin-resistant enterococci (VRE) of the vanA genotype; 12 E. faecium (f rom 11 patients) and two E. faecalis (ICU patients: 5.8%, general ward pati ents: 5.4%, outpatients: 6.7%). None of the faecal specimens from healthy v olunteers or animals yielded VRE. Nine of the 13 patients harbouring VRE ha d received antibiotic therapy during the previous four weeks (broad-spectru m cephalosporins: six patients; i.v. vancomycin: five patients). Of the 14 VRE (vanA type) isolates sis strains were indistinguishable by PFGE using S maI as restriction endonuclease, six strains formed three pairs, and only t wo single isolates showed unique patterns. The results of our study support s the view that nosocomial cross transmission is currently the main cause o f colonization and infection with VRE in Austria. (C) 2000 The Hospital Inf ection Society.