Pulsed field gel electrophoresis typing of coagulase-negative staphylococci with decreased susceptibility to teicoplanin isolated from an intensive care unit

Increased isolation of coagulase-negative staphylococci (CoNS) with decreas ed susceptibility to teicoplanin prompted this epidemiological survey in th e authors intensive care unit. Of 224 medical and surgical patients with he patobiliary disease, in hospital between December 1998 and July 1999, 14 (6 .3%) had at least one isolate of CoNS with decreased susceptibility to teic oplanin. A total of 27 isolates with decreased susceptibility to teicoplani n were recovered from these 14 patients. Pulsed field electrophoresis (PFGE ) with SmaI endonuclease demonstrated that CoNS isolates obtained from diff erent patients were unrelated. In addition, different isolates obtain from the same patient were also unrelated, with the exception of two patients. E ighteen out of 27 isolates (66.7%) with decreased susceptibility to teicopl anin were recovered after an earlier treatment with teicoplanin or vancomyc in (median 13.1 g, range 2.4-32.7 g per patient). Only four CoNS strains wi th decreased susceptibility to teicoplanin induced serious infection, all o f which responded well to vancomycin therapy. Emergence of CoNS strains with decreased susceptibility to teicoplanin rema ined limited in hospitalized patients, and was not related to a clonal spre ad of a particular resistant strain. (C) 2001 The Hospital Infection Societ y.