PMID- 7868404
OWN - NLM
STAT- MEDLINE
DCOM- 19950324
LR  - 20190512
IS  - 0305-7453 (Print)
IS  - 0305-7453 (Linking)
VI  - 34
IP  - 4
DP  - 1994 Oct
TI  - Faecal carriage and nosocomial spread of vancomycin-resistant Enterococcus 
      faecium.
PG  - 515-28
AB  - Eight clinical isolates of vancomycin-resistant Enterococcus faecium (VRE) were 
      obtained from four renal and four other in-patients within an 11 week period 
      during 1992. Characterisation of the isolates by restriction enzyme analysis with 
      Sal I and rRNA gene restriction patterns (ribotyping) showed them to be clonally 
      related. During the next 3 months an additional 14 VRE were isolated from 
      hospital patients, nine of which were indistinguishable by ribotyping from the 
      strain associated with the outbreak. An epidemiological survey was instigated in 
      order to determine the level of carriage of this VRE. A total of 354 stool 
      specimens was screened using a highly selective enrichment broth. VRE were 
      detected in the stools of 11/73 (15%) of renal patients, 5/97 (5%) of other 
      hospital patients and 3/184 (2%) of patients based in the community. Of the 25 
      stool isolates that were further characterised by ribotyping, 17 were 
      indistinguishable from the outbreak strain. The remaining eight isolates gave 
      seven different patterns. Patients harbouring the outbreak strain stayed in 
      hospital significantly longer and had received more antibiotic treatment, for 
      longer, than those patients from whom other VRE had been isolated. There was no 
      significant difference in vancomycin or cephalosporin usage between the two 
      groups of patients. Ribotyping showed there to be a number of clones of VRE 
      carried by patients and that one of these clones was especially prevalent and has 
      been responsible for the outbreak of infection in the renal unit. The technique 
      also showed the presence of different VRE in general practice patients suggesting 
      they are not just a hospital phenomenon.
FAU - Jordens, J Z
AU  - Jordens JZ
AD  - Public Health Laboratory, University of Oxford, John Radcliffe Hospital, 
      Headington, UK.
FAU - Bates, J
AU  - Bates J
FAU - Griffiths, D T
AU  - Griffiths DT
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - England
TA  - J Antimicrob Chemother
JT  - The Journal of antimicrobial chemotherapy
JID - 7513617
RN  - 0 (Culture Media)
RN  - 6Q205EH1VU (Vancomycin)
SB  - IM
GS  - vanA
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cross Infection/epidemiology/*microbiology/transmission
MH  - Culture Media
MH  - DNA Fingerprinting
MH  - Drug Resistance, Microbial
MH  - *Enterococcus faecium/drug effects/genetics
MH  - Feces/*microbiology
MH  - Female
MH  - Gram-Positive Bacterial Infections/epidemiology/*microbiology/transmission
MH  - Humans
MH  - Male
MH  - Microbial Sensitivity Tests
MH  - Middle Aged
MH  - Polymerase Chain Reaction
MH  - Restriction Mapping
MH  - United Kingdom/epidemiology
MH  - Vancomycin/*pharmacology
EDAT- 1994/10/01 00:00
MHDA- 1994/10/01 00:01
CRDT- 1994/10/01 00:00
PHST- 1994/10/01 00:00 [pubmed]
PHST- 1994/10/01 00:01 [medline]
PHST- 1994/10/01 00:00 [entrez]
AID - 10.1093/jac/34.4.515 [doi]
PST - ppublish
SO  - J Antimicrob Chemother. 1994 Oct;34(4):515-28. doi: 10.1093/jac/34.4.515.