INTRAHOSPITAL SPREAD OF VANCOMYCIN-RESISTANT ENTEROCOCCUS-FAECIUM IN SWEDEN

During a 17-week period vancomycin-resistant Enterococcus faecium (VRE ) was found in clinical specimens from 4 in-patients. All bacterial is olates were phenotypically VanA, showing high-level resistance to vanc omycin (MIC 256 mu g/ml) and teicoplanin (MIC 24-256 mu g/ml). The cor responding gene (vanA) was detected with PCR in strains from 3 of the patients. Three patients had been hospitalized at the renal unit at Or ebro Medical Centre Hospital (OMCH). The fourth patient, diagnosed in another hospital, bad received treatment in the oncology unit at OMCH. All patients recovered without treatment specific for VRE. Isolates f rom 2 patients were indistinguishable by pulsed-field gel electrophore sis of genomic DNA. Genetically, these strains were related to the VRE isolates from the 2 other patients. Screening of hospital staff and o ther in-patients for gastrointestinal carriage of VRE was negative. Gl ycopetide-resistant enterococci have not previously been found in OMCH . No nea cases were identified during a 10-month follow-up period. Our cases represent the first nosocomial outbreak of VRE in Sweden.