Colonization by vancomycin-resistant enterococci of the intestinal tract of patients in intensive care units from French general hospitals

Abstract

OBJECTIVE: To evaluate the prevalence of fecal carriage of vancomycin-resistant enterococci (VRE) by patients hospitalized in intensive care units from 24 French general hospitals. METHODS: Rectal swabs were obtained from 647 patients hospitalized in intensive care units during the month of June 1994 and plated on agar medium selective for vancomycin-resistant enterococci. The glycopeptide resistance phenotypes and genotypes of the enterococci detected were characterized. RESULTS: Thirty-two of 647 patients (4.9%) carried VRE. Thirteen strains (2%) were identified as Enterococcus faecium and 19 (2.9%) as Enterococcus gallinarum or Enterococcus casseliflavus. None of these strains was highly resistant to gentamicin. The E. gallinarum and E. casseliflavus strains contained the vanC1 and vanC2 genes, respectively. The E. faecium strains were highly resistant to vancomycin and teicoplanin and carried the vanA gene. No infection due to VRE was observed during the study period. Pulsed-field gel analysis of total DNA following digestion with SmaI or KspI from 13 VanA-type E. faecium strains revealed intra- and inter-hospital strain heterogeneity. However, the finding of isolates with indistinguishable pulsed-field types within the same ward and in two medical centers suggests patient-to-patient transmission or a common source. Four E. faecium strains were isolated within 48 h after admission of patients. CONCLUSIONS: These results indicate that VRE form part of the normal flora of patients and that, despite the actual scarcity of infections due to VRE, there is a potential risk for dissemination of these strains in French hospitals.

Prevalence and Molecular Epidemiology of Glycopeptide‐Resistant Enterococci in Belgian Renal Dialysis Units

“…Still, VANA isolates predominate in the United Kingdom [36]. In Belgium and The Netherlands, VANB isolates were infrequently found in some studies [11,37,38], whereas others [39][40][41][42] did not detect them. In contrast, VANB-associated outbreaks are frequently reported in the United States [43][44][45].…”

Vancomycin-resistant enterococci, colonizing the intestinal tract of patients in a university hospital in greece

“…In our study, 39 patients (30.5%) were found to have VRE: 10 (7.8%) in the ICU, 14 (10.9%) in surgical wards and 15 (11.7%) in internal medicine wards. The prevalence of fecal colonization by VRE reported in other European studies was: 2% in the Netherlands [21], 4.9% in ICUs of French general hospitals [22] and 3.5% in Belgium [23].…”

Distribution and Evaluation of Vancomycin Resistant Enterococci Seen in Selcuk University Medical Faculty Hospital between 2012 and 2015

“…Yayılımın engellenmesi için riskli hastalardan perirektal ve rektal sürüntü ör-neği alınması önerilmektedir [9] . Hollanda'da dokuz hastanenin hematoloji-onkoloji ve yoğun bakım üni-telerinde yatan 624 hastanın rektal sürüntü örnek-lerinin değerlendirildiği çok merkezli bir çalışmada VRE kolonizasyonu %2, Belçika'da 800 yataklı bir hastanede yapılan nokta prevalans çalışmasında %3.5, Fransa'da 24 hastanede 647 yoğun bakım hastasında yapılan çok merkezli bir çalışmada ise %4.9 olarak bildirilmiştir [10][11][12] . Gambarotto ve arkadaşlarının Fransa'da hematoloji yoğun bakım ünitesinde VRE'de fekal kolonizasyonu araştırmaya yönelik yaptığı bir çalışmada VRE kolonizasyon oranı %37 olarak bildirilmiştir [13] .…”

“…Yüksek düzey gentamisin direnci %87.5, tetrasiklin direnci %80. 4 [11,12,16,40] . Nispeten daha az olsa da E. casseliflavus ve E. gallinarum'un da en sık etken olarak bildirildiği çalışmalar da vardır [13] .…”