TY - JOUR
T1 - An outbreak of vancomycin-dependent Enterococcus faecium in a bone marrow transplant unit
AU - Kirkpatrick, Beth D.
AU - Harrington, S. M.
AU - Smith, D.
AU - Marcellus, D.
AU - Miller, C.
AU - Dick, J.
AU - Karanfil, L.
AU - Perl, T. M.
PY - 1999
Y1 - 1999
N2 - Outbreaks of vancomycin-resistant enterococci (VRE) are well described. The presence of mutants of VRE, such as vancomycin-dependent enterococci (VDE), in individual patients has been documented, but their potential to spread nosocomially has not been known. We present the first cluster of patients who acquired VDE nosocomially. Five bone marrow transplantation patients were infected or colonized by a genotypically indistinguishable multiantibiotic-resistant strain of Enterococcus faecium. Vancomycin dependence in 3 of the 5 isolates was demonstrated. All cluster patients had received protracted prophylactic treatment with vancomycin (mean, 22.6 days), and specimens from ≥ 2 body sites were repeatedly culture-positive for the outbreak strain. The outbreak was controlled with aggressive infection control strategies, and prophylactic antibiotic policies were revised. Awareness of the potential for nosocomial spread of multiantibiotic-resistant VDE is vital for the care of immunocomproised patients, especially those receiving prophylactic antibiotics.
AB - Outbreaks of vancomycin-resistant enterococci (VRE) are well described. The presence of mutants of VRE, such as vancomycin-dependent enterococci (VDE), in individual patients has been documented, but their potential to spread nosocomially has not been known. We present the first cluster of patients who acquired VDE nosocomially. Five bone marrow transplantation patients were infected or colonized by a genotypically indistinguishable multiantibiotic-resistant strain of Enterococcus faecium. Vancomycin dependence in 3 of the 5 isolates was demonstrated. All cluster patients had received protracted prophylactic treatment with vancomycin (mean, 22.6 days), and specimens from ≥ 2 body sites were repeatedly culture-positive for the outbreak strain. The outbreak was controlled with aggressive infection control strategies, and prophylactic antibiotic policies were revised. Awareness of the potential for nosocomial spread of multiantibiotic-resistant VDE is vital for the care of immunocomproised patients, especially those receiving prophylactic antibiotics.
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U2 - 10.1086/313456
DO - 10.1086/313456
M3 - Article
C2 - 10524974
AN - SCOPUS:0033509048
SN - 1058-4838
VL - 29
SP - 1268
EP - 1273
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 5
ER -