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JAC Advance Access published online on May 26, 2004

Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkh293
© 2004 by The British Society for Antimicrobial Chemotherapy
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Received February 27, 2004
Revised April 19, 2004
Accepted April 21, 2004

Brief report

Substantially increased faecal carriage of vancomycin-resistant enterococci in a tertiary Greek hospital after a 4 year time interval

D. Sofianou 1, S. Pournaras 2, M. Giosi 1, A. Polyzou 1, A. N. Maniatis 2, A. Tsakris 3*

1 Department of Microbiology, Hippokration University Hospital, Thessaloniki, Greece
2 Department of Medical Microbiology, University of Thessalia, Larissa, Greece
3 Department of Microbiology, Faculty of Nursing, School of Health Sciences, University of Athens, 123 Papadiamantopoulou Street, 11527 Athens, Greece

* To whom correspondence should be addressed. E-mail: atsakris{at}med.uoa.gr.


   Abstract

Objectives: In a tertiary Greek hospital with no documented vancomycin-resistant enterococci (VRE) infections, a cross-sectional study was conducted in order to determine the degree of VRE faecal carriage among adult patients hospitalized in high-risk units.

Methods: Specimens for the surveillance were collected from separate patients in two periods (January-May 1999 and January-May 2003); 258 specimens were submitted during the first period and 149 during the second period.

Results: Three patients (1.2%) were colonized with VRE during the first period, whereas 52 (34.9%) were colonized during the second period. Two VRE isolates of the first period were Enterococcus faecalis and one Enterococcus faecium, whereas those of the second period were E. faecium except for three E. faecalis and two Enterococcus gallinarum. All VRE isolates apart from the two E. gallinarum isolates were positive for the vanA gene. The 48 vancomycin-resistant E. faecium were classified into eight clonal types, one of those predominating with 29 isolates; the remaining included one to nine isolates. The five vancomycin-resistant E. faecalis formed four distinct clonal types.

Conclusions: The study reports a substantially higher prevalence of VRE carriage when the surveillance was repeated after a 4 year time interval. Urgent infection control measures are needed to prevent emergence of VRE outbreaks in our hospital setting.

Key Words: Keywords: VRE, surveillance, genotyping


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