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High-level vancomycin-resistant enterococci causing hospital infections

Published online by Cambridge University Press:  15 May 2009

A. H. C. Uttley ,
R. C. George ,
J. Naidoo ,
N. Woodford ,
A. P. Johnson ,
C. H. Collins ,
D. Morrison ,
A. J. Gilfillan ,
L. E. Fitch  and
J. Heptonstall
A. H. C. Uttley
Affiliation:
Public Health Laboratory, Dulwich Hospital, East Dulwich Grove, London SE22 8QF
R. C. George
Affiliation:
Antibiotic Reference Laboratory, Division of Hospital Infection, Central Public Health Laboratory
J. Naidoo
Affiliation:
Antibiotic Reference Laboratory, Division of Hospital Infection, Central Public Health Laboratory
N. Woodford
Affiliation:
Antibiotic Reference Laboratory, Division of Hospital Infection, Central Public Health Laboratory
A. P. Johnson
Affiliation:
Antibiotic Reference Laboratory, Division of Hospital Infection, Central Public Health Laboratory
C. H. Collins
Affiliation:
Public Health Laboratory, Dulwich Hospital, East Dulwich Grove, London SE22 8QF
D. Morrison
Affiliation:
Streptococcus Reference Laboratory, Division of Hospital Infection, Central Public Health Laboratory
A. J. Gilfillan
Affiliation:
Antibiotic Reference Laboratory, Division of Hospital Infection, Central Public Health Laboratory
L. E. Fitch
Affiliation:
Public Health Laboratory, Dulwich Hospital, East Dulwich Grove, London SE22 8QF
J. Heptonstall
Affiliation:
Public Health Laboratory, Dulwich Hospital, East Dulwich Grove, London SE22 8QF
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Summary

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Nosocomial infection or colonization due to enterococci with high-level resistance to vancomycin (minimal inhibitory concentrations [MICs] between 64 and > 2000 mg/L) has occurred in 41 patients with renal disease. These vancomycin-resistant enterococci were cultured from many sources including blood. All but one strain contained one or more plasmids ranging in molecular weight from 1·0 to 40 Megadaltons (MDa). Vancomycin resistance was transferable by conjugation to a susceptible recipient strain of Enterococcus faecalis but this was not always associated with plasmid DNA. The emergence of transferable high-level vancomycin resistance in enterococci causing significant clinical infections is of particular importance since vancomycin is widely regarded as a reserve drug for the management of infections with multi-resistant Gram-positive organisms.

Type
Special Article
Information
Epidemiology & Infection , Volume 103 , Issue 1 , August 1989 , pp. 173 - 181
Copyright
Copyright © Cambridge University Press 1989

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