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Journal of Antimicrobial Chemotherapy (2002) 50, 397-401
© 2002 The British Society for Antimicrobial Chemotherapy

First outbreak of vancomycin-resistant enterococci in a tertiary hospital in Turkey

Dilek Colak1,2, Thierry Naas2,*, Filiz Gunseren3, Nicolas Fortineau2, Dilara Ogunc1, Meral Gultekin1 and Patrice Nordmann2

1 Clinical Microbiology and 3 Infectious Diseases Departments, Akdeniz University School of Medicine, Antalya, Turkey; 2 Service de Bactériologie-Virologie, Hôpital de Bicêtre, 78 rue du Général Leclerc, Assistance Publique/Hôpitaux de Paris, Faculté de Médecine Paris-Sud, 94275 Le Kremlin-Bicêtre Cedex, France

Received 21 January 2002; returned 8 April 2002; revised 24 May 2002; accepted 5 June 2002

Twenty multidrug-resistant vancomycin-resistant Enterococcus faecium strains of the VanA phenotype were isolated over a 1 year period from five patients in the intensive care unit at the University Hospital of Antalya, Turkey. Molecular investigation showed that these strains belonged to five different pulsotypes and that the vanA gene was carried by a Tn1546-like transposon inserted onto a self-transferable plasmid of approximately 200 kb. One patient was infected by two different strains, suggesting horizontal gene transfer within that patient. This is the first documented outbreak of VRE in Turkey with concomitant spread of plasmid and strains.

Keywords: Enterococcus faecium, VRE, outbreak

* Corresponding author. Tel: +33-1-45-21-36-24; Fax: +33-1-45-21-63-40; E-mail: thierry.naas{at}bct.ap-hop-paris.fr


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