VRE in the Republic of Ireland: clinical significance, characteristics andmolecular similarity of isolates

There have been increasing reports worldwide of vancomycin resistant entero cocci (VRE) since they Mere first noted over ten years ago. This study soug ht to investigate the clinical significance of VRE in Ireland And to compar e the phenotypic, genotypic and molecular characteristics of isolates recov ered from patients in different institutions. The relative contribution of inter-hospital transmission of strains to the dissemination of VRE in Irela nd was assessed. Hospital surveillance for VRE is not well established in Ireland. The organ ism has been detected in sei en hospitals. Detection has been predominantly in oncology inpatients in large tertiary referral hospitals in the Dublin metropolitan area in whom strains generally represent asymptomatic gastroin testinal tract colonization. The predominant species is E. faecium with the Van A resistance phenotype. Twenty-seven (87%) of 31 isolates from one uni t Mere shown to be of the same or closely related strain as were 10 (63%) o f 16 from another unit, indicating significant nosocomial transmission with in institutions. There was no evidence for inter-hospital transmission of V RE. VRE is established in Ireland and nosocomial transmission readily occurs. R egular surveillance for VRE is indicated in high-risk populations in large institutions, specific risk factors for the acquisition of VRE need to be d efined and optimal control and preventative strategies need to be institute d re, detect and pre-empt the spread of this organism. (C) 2000 The Hospita l Infection Society.