Emergence of vancomycin-resistant enterococci in New York City

Frieden, T.R.; Munsiff, Sonal S.; Williams, Gordon R.; Faur, Yvonne C.; Kreiswirth, Barry N; Low, Donald E.; Willey, Barbara M.; Warren, Steven B.; Eisner, William

doi:10.1016/0140-6736(93)91285-t

Cited by 320 publications

(168 citation statements)

References 17 publications

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“…The infections caused by enterococci are a major issue in hospital settings (7,25,29). These microorganisms are innately more resistant to many of the antimicrobials used in hospitals, something which provides them some selective advantage (24,25).…”

Section: Introductionmentioning

confidence: 99%

“…These microorganisms are innately more resistant to many of the antimicrobials used in hospitals, something which provides them some selective advantage (24,25). Surveys carried out in the United States show that enterococci are the second leading microorganism among those causing surgical infections and nosocomial infections of the urinary tract, and the third among those causing hospital infections in general (7,29).…”

Section: Introductionmentioning

confidence: 99%

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Antimicrobial susceptibility among Enterococcus isolates from the city of Porto Alegre, RS, Brazil

d’Azevedo

Dias

Lemos³

et al. 2004

Braz. J. Microbiol.

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Resistance to several classes of antimicrobial agents is a remarkable characteristic of enterococcal strains increasingly reported worldwide. Information about strains isolated in the southern region of Brazil is still limited. In this study, a total of 455 consecutive enterococcal isolates recovered from patients living in Porto Alegre, Brazil, were identified at species level and evaluated for their antimicrobial susceptibilities by agar diffusion testing. The most frequent species was E. faecalis (92.8%), followed by E. faecium (2.9%), E. gallinarum (1.5%), E. avium (1.1%), E. hirae (0.7%), E. casseliflavus (0.4%), E. durans (0.4%), and E. raffinosus (0.2%). According to the results of disk tests 62.0% of the strains were resistant to tetracycline, 42.6% to erythromycin, 24.8% to chloramphenicol, 22.6% to ciprofloxacin, 22.0% to norfloxacin, 3.5% to ampicillin, 3.5% to nitrofurantoin. High level resistance to aminoglycosides was found in 37.8% of the isolates, with 23.5% being resistant to gentamicin, 14.3% to streptomycin, and 2.8% to both gentamicin and streptomycin. No vancomycin resistant or b-lactamase producing isolates were found. The results indicate that a significant percentage of isolates are resistant to different antimicrobials, pointing out the need for control strategies to avoid dissemination of resistant isolates and for continuous surveillance for the detection of emerging resistance traits.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Antimicrobial susceptibility among Enterococcus isolates from the city of Porto Alegre, RS, Brazil

d’Azevedo

Dias

Lemos³

et al. 2004

Braz. J. Microbiol.

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“…Therefore, at least 80% of febrile neutropenic patients could be overtreated with a glycopeptide antibiotic when such ther apy is given routinely initially^ leading to unnecessary costs, increased risk of toxicity and the potential for the development of antibiotic resistance [9,10], Patients at high risk of grampositive infection may be those most likely to benefit from the empirical addition of a glycopeptide, but it is questionable whether they can be identified at the onset of fever. Based on our previous experience [11], we hypothesised that these were likely to be patients with skin and soft tissue infection such as cellulitis, catheter-related infections and other skin lesions, and so they were given vancomycin in addition to the core regimen of ceftazidime or piperacillin and tobramycin as part of a large multicentre randomised trial of the empirical treat ment of fever in neutropenic patients with cancer [12].…”

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confidence: 99%

Early identification of neutropenic patients at risk of gram-positive bacteraemia and the impact of empirical administration of vancomycin

Dompeling

Donnelly

Deresinski

et al. 1996

European Journal of Cancer

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The aim o f this m ulticentre randomised trial was to determine whether it was possible to predict grampositive bacteraem ia, and whether the em pirical use o f vancomycin would lead to reduced morbidity and mortality. 35 o f 113 patients (31%; confidence interval. Cl 8.5), who presented with a skin or soft tissue infection and had received empirical vancomycin in addition to either ceftazidime or piperacillin-tobram ycin, had initial bacteraemia with a single gram-positive bacterium compared with 135 of the 784 (17%; C l 2.6), who presented with another infection and who had been given ceftazidime or piperacillin-tobram ycin without vancomycin (P<0.G01). Empirical vancomycin resulted in a higher rate of eradication (P = 0.033, relative risk 1.2), but not a better clinical outcome and was associated with more toxicity (P=0.042, relative risk 1.6). Irrespective of the initial treatment regimen, fever lasted an average of 8 days, the em pirical regimen was modified in more than 50% of cases and mortality attributed to gram-positive infection was less than 2%. Incorporating vancomycin in the initial em pirical antibiotic regimen for febrile neutropenic patients does not appear necessary, even for skin and soft tissue infections associated with gram -positive bacteraemia.

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“…However, in Brazil avoparcin is used in production farms. Frieden et al suggested that the glycopeptide-resistance in enterococci was originated in hospitals, by inapropriate use, and then spread to the comunity (18).…”

Section: Discussionmentioning

confidence: 99%

Glycopeptides susceptibility among enterococci isolated from a poultry farm in São Paulo, Brazil (1996/1997)

Leme¹,

Ferreira²,

Bottino³

et al. 2000

Braz. J. Microbiol.

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Enterococci resistance to glycopeptides was evaluated em Brazilian poultry fed with feed supplemented with avoparcin as growth promoter. The susceptibility to the glycopeptides avoparcin, teicoplanin and vancomycin was determined for 217 enterococci isolated from cloacal swabs (one swab per bird) in tests and controls groups. Tests group comprised three groups (A, B and C) of Hubbard broiler-chickens 14, 21 and 35 days old, respectively. These birds were from one single farm, with a common feed source supplemented with avoparcin (10 mg/kg of feed). Controls groups (1 and 2) comprised 25 and 42 days old broilers, respectively, obtained from the Faculty of Veterinary Medicines aviary (University of São Paulo) where avoparcin was never used. No glycopeptide resistant enterococci strain was found, but an increase of Enterococcus faecium in faeces of chickens fed with avoparcin, independent of the age of the bird, was detected.

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Emergence of vancomycin-resistant enterococci in New York City

Cited by 320 publications

References 17 publications

Antimicrobial susceptibility among Enterococcus isolates from the city of Porto Alegre, RS, Brazil

Antimicrobial susceptibility among Enterococcus isolates from the city of Porto Alegre, RS, Brazil

Early identification of neutropenic patients at risk of gram-positive bacteraemia and the impact of empirical administration of vancomycin

Glycopeptides susceptibility among enterococci isolated from a poultry farm in São Paulo, Brazil (1996/1997)

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