Epidemiology of an outbreak due to glycopeptide-resistant Enterococcus faecium on a leukaemia unit.

2.50
Hdl Handle:
http://hdl.handle.net/10541/96042
Title:
Epidemiology of an outbreak due to glycopeptide-resistant Enterococcus faecium on a leukaemia unit.
Authors:
Chadwick, P R; Oppenheim, B A; Fox, A; Woodford, N; Morgenstern, Godfrey R; Scarffe, J Howard
Abstract:
The clinical and molecular epidemiology of two clusters of colonization and infection of patients by glycopeptide-resistant enterococci (GRE) on a leukaemia and bone marrow transplantation unit was studied over a two-and-a half-year period. Thirty-five patients became colonized, of whom six developed clinical infections. Of the 53 isolates of GRE, 49 were Enterococcus faecium, multiply-resistant to vancomycin and ampicillin. DNA fingerprinting of 48 E. faecium isolates by pulsed-field gel electrophoresis identified six DNA types. One strain of VanB phenotype E. faecium predominated during the initial outbreak, and an unrelated strain of the VanA phenotype was present in a second cluster. Environmental and patient isolates of E. faecium were indistinguishable by DNA typing. The VanA phenotype enterococci probably arose by transfer from the renal ward at a nearby hospital, and a patient with persistent diarrhoea may have contributed to contamination and cross-infection. GRE may cause significant infections in immunocompromised patients, and are readily transmitted between them. GRE were controlled, but not eradicated on the unit; infection control measures included improved environmental cleaning and modification of antibiotic use. In order to control GRE, it is necessary to educate healthcare workers and implement the traditional, effective values of good personal hygiene and environmental cleanliness.
Affiliation:
Public Health Laboratory, Withington Hospital, Manchester, UK.
Citation:
Epidemiology of an outbreak due to glycopeptide-resistant Enterococcus faecium on a leukaemia unit. 1996, 34 (3):171-82 J. Hosp. Infect.
Journal:
The Journal of Hospital Infection
Issue Date:
Nov-1996
URI:
http://hdl.handle.net/10541/96042
DOI:
10.1016/S0195-6701(96)90063-8
PubMed ID:
8923271
Type:
Article
Language:
en
ISSN:
0195-6701
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorChadwick, P Ren
dc.contributor.authorOppenheim, B Aen
dc.contributor.authorFox, Aen
dc.contributor.authorWoodford, Nen
dc.contributor.authorMorgenstern, Godfrey Ren
dc.contributor.authorScarffe, J Howarden
dc.date.accessioned2010-04-08T15:56:07Z-
dc.date.available2010-04-08T15:56:07Z-
dc.date.issued1996-11-
dc.identifier.citationEpidemiology of an outbreak due to glycopeptide-resistant Enterococcus faecium on a leukaemia unit. 1996, 34 (3):171-82 J. Hosp. Infect.en
dc.identifier.issn0195-6701-
dc.identifier.pmid8923271-
dc.identifier.doi10.1016/S0195-6701(96)90063-8-
dc.identifier.urihttp://hdl.handle.net/10541/96042-
dc.description.abstractThe clinical and molecular epidemiology of two clusters of colonization and infection of patients by glycopeptide-resistant enterococci (GRE) on a leukaemia and bone marrow transplantation unit was studied over a two-and-a half-year period. Thirty-five patients became colonized, of whom six developed clinical infections. Of the 53 isolates of GRE, 49 were Enterococcus faecium, multiply-resistant to vancomycin and ampicillin. DNA fingerprinting of 48 E. faecium isolates by pulsed-field gel electrophoresis identified six DNA types. One strain of VanB phenotype E. faecium predominated during the initial outbreak, and an unrelated strain of the VanA phenotype was present in a second cluster. Environmental and patient isolates of E. faecium were indistinguishable by DNA typing. The VanA phenotype enterococci probably arose by transfer from the renal ward at a nearby hospital, and a patient with persistent diarrhoea may have contributed to contamination and cross-infection. GRE may cause significant infections in immunocompromised patients, and are readily transmitted between them. GRE were controlled, but not eradicated on the unit; infection control measures included improved environmental cleaning and modification of antibiotic use. In order to control GRE, it is necessary to educate healthcare workers and implement the traditional, effective values of good personal hygiene and environmental cleanliness.en
dc.language.isoenen
dc.subjectLeukaemiaen
dc.subject.meshAdult-
dc.subject.meshAnti-Bacterial Agents-
dc.subject.meshCross Infection-
dc.subject.meshDNA Fingerprinting-
dc.subject.meshDNA, Bacterial-
dc.subject.meshDisease Outbreaks-
dc.subject.meshDrug Resistance, Microbial-
dc.subject.meshEngland-
dc.subject.meshEnterococcus faecium-
dc.subject.meshFemale-
dc.subject.meshGram-Positive Bacterial Infections-
dc.subject.meshHumans-
dc.subject.meshInfection Control-
dc.subject.meshLeukemia-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshVancomycin-
dc.titleEpidemiology of an outbreak due to glycopeptide-resistant Enterococcus faecium on a leukaemia unit.en
dc.typeArticleen
dc.contributor.departmentPublic Health Laboratory, Withington Hospital, Manchester, UK.en
dc.identifier.journalThe Journal of Hospital Infectionen

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