Korean J Infect Dis.  2000 Aug;32(4):315-324.

Molecular Epidemiology and Surveillence of Vancomycin-resistant Enterococci at Seoul National University Hospital

• Lee SH
• Park SW
• Kim HB
• Kim US
• Kim T
• Oh HS
• Oh MD
• Kim EC
• Choe KW

Abstract

BACKGROUND
The purpose of this study is to investigate the epidemiology and microbiological susceptibility patterns of vancomycin-resistant enterococci (VRE) in Seoul National University Hospital.
METHODS
The VRE isolates between May 1998 and October 1999 were studied. We reviewed the medical records of VRE-isolated patients for clinical and epidemiologic data. The susceptibility of VRE to ampicillin, vancomycin, teicoplanin, gentamicin, streptomycin, ciprofloxacin, imipenem, rifampin, tetracyclin were determined by micro-dilution method. PCR for genotyping and PFGE for molecular epidemiology were performed.
RESULTS
Twenty-nine VRE isolates were identified from 14 patients, 12 patients from clinical specimens and two from only rectal surveillence cultures. All strains were E. faecium and expressed vanA genotype. The vancomycin MIC and teicoplanin MIC were >128microgram/mL for all isolates. All isolates also resistant to most other antibiotics tested (ampicillin 84.2%, gentamicin 73.7%, streptomycin 73.7%, ciprofloxacin 84.2%, tetracycline 63.2%, rifampin 84.2%, imipenem 94.7%). PFGE analysis revealed 17 distinct PFGE strain types from 14 patients and there were no predominent types. Two patterns, each of them represented by two isolates, were identical. One of which was not associated epidemiologically but the other was associated with direct spread from colonized patient at the intensive care unit.
CONCLUSION
The majority of VRE cases occurring at Seoul National University Hospital were not caused by epidemiologic strains but sporadic isolations although there was one case of patient to patient spread.

Keyword

Vancomycin-resistant enterococcus; Ep-idemiology; Pulsed-field gel electrophoresis; Polymerase chain reaction

MeSH Terms

Ampicillin
Anti-Bacterial Agents
Ciprofloxacin
Colon
Electrophoresis, Gel, Pulsed-Field
Epidemiology
Genotype
Gentamicins
Humans
Imipenem
Intensive Care Units
Medical Records
Molecular Epidemiology*
Polymerase Chain Reaction
Rifampin
Seoul*
Streptomycin
Teicoplanin
Tetracycline
Vancomycin
Ampicillin
Anti-Bacterial Agents
Ciprofloxacin
Gentamicins
Imipenem
Rifampin
Streptomycin
Teicoplanin
Tetracycline
Vancomycin