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JAC Advance Access published online on December 4, 2003
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkh035
© 2003 by The British Society for Antimicrobial Chemotherapy
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© 2003 The British Society for Antimicrobial Chemotherapy

Brief report

Persistence of a clone of glycopeptide-resistant Enterococcus faecalis among patients in an intensive care unit of a Greek hospital

Spyros Pournaras 1 *, Helen Malamou-Lada 2 , Maria Maniati 1 , Dimitra Mylona-Petropoulou 2 , Helen Vagiakou-Voudris 2 , Athanassios Tsakris 3 , and Antonios N. Maniatis 1

1 Department of Medical Microbiology, University of Thessalia, Larissa;
2 Department of Clinical Microbiology, G. Gennimatas General Hospital, Athens;
3 Department of Microbiology, Faculty of Nursing, School of Health Sciences, University of Athens, Athens, Greece

* Corresponding author. E-mail: pournaras{at}med.uth.gr.

Received 21 August 2003 ; revised 16 October 2003 ; accepted 23 October 2003

Abstract

Objectives: To investigate an outbreak of glycopeptide-resistant Enterococcus faecalis (GREF) in the intensive care unit (ICU) of ‘G. Gennimatas’ General Hospital, Athens, Greece.

Materials and methods: Between August 2000 and November 2001, 20 highly GREF isolates were recovered from severe infections of separate patients in the ICU. The isolates were tested by PCR, PFGE, mating experiments and plasmid analysis.

Results: All isolates carried the vanA gene. Nineteen isolates fitted to one clone by macrorestriction analysis with four subclones being consecutively detected. Each subclone seemed to predominate for a specific time period. Additionally, four GREF isolates related to the ICU clone were recovered from other wards of the hospital.

Conclusions: Our findings indicate that a monoclonal GREF outbreak persisted for more than 1 year in a large Greek hospital. The rate of GREF isolation declined after the application of infection control measures.

Keywords: glycopeptide resistance, Enterococcus faecalis clone, outbreak
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