JAC Advance Access published online on January 6, 2003
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkg052
© 2003 by The British Society for Antimicrobial Chemotherapy
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Original article
1 University of Tromsø and
University Hospital of North Norway (UNN)
* Corresponding author. E-mail: arnfinns{at}fagmed.uit.no.
Received 24 September 2002
; accepted 19 October 2002
We determined the species distribution and prevalence
of ampicillin resistance, high-level gentamicin resistance (HLGR)
and vancomycin resistance among clinical enterococcal isolates from
five Nordic laboratories (Bergen, Tromsø, Uppsala, Aarhus
and Reykjavik). Isolates represented three different groups: (i)
all blood culture isolates from 1999; (ii) consecutive in-patient isolates
(maximum 40); and (iii) consecutive outpatient isolates (maximum
40) collected during March to May 2000. Antimicrobial use data were
collected at the national and hospital level. A high proportion
(31.4%) of Enterococcus faecium was detected
among blood culture isolates, in contrast to only 4.2% among
isolates from outpatients. Ampicillin resistance was not found in Enterococcus faecalis, in contrast to 48.8% in E. faecium isolates. HLGR rates varied considerably
between laboratories (1.1-27.6%). Acquired vancomycin
resistance was not detected. There were no significant differences
in the prevalences of HLGR between in-patient and outpatient isolates
at individual hospitals. A cluster of clonally related ampicillin-resistant
and HLGR E. faecium isolates was demonstrated in
one of the hospitals. The lowest level of hospital antimicrobial
use, the lowest proportion of E. faecium and the
lowest prevalence of resistance were observed in Reykjavik.The study
showed a relatively low level of resistance in enterococci, as compared
with most European countries and the USA. However, there were large
differences between hospitals with regard to the relative proportion
of E. faecium isolates, their susceptibility to
ampicillin and gentamicin, as well as the prevalence of HLGR in E. faecalis isolates. This indicates a potential
for further improvement of antibiotic policies, and possibly hospital
infection control, to maintain the low resistance levels observed
in these countries.
Keywords: enterococci, antimicrobial resistance, antimicrobial
use
Prevalence of resistance to ampicillin, gentamicin
and vancomycin in Enterococcus faecalis and Enterococcus
faecium isolates from clinical specimens and use of antimicrobials
in five Nordic hospitals
2 Statens Serum Institut, Denmark
3 Aarhus University Hospital, Denmark
4 Landspitali University Hospital,
Reykjavik, Iceland
5 Uppsala University Hospital, Sweden
6 Haukeland University Hospital, Norway
7 University of Tromsø and
University Hospital of North Norway (UNN); Reference Center for Detection
of Antimicrobial Resistance, UNN, Norway
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