The Reason of High Prevalence of Vancomycin-Resistant (VR) E. faecium in Nosocomial Infection

  • Jo, Hyun-Jung (Department of Clinical Laboratory Science, College of Health Sciences, Catholic University of Pusan) ;
  • Kim, Hee-Jeong (Department of Clinical Laboratory Science, College of Health Sciences, Catholic University of Pusan) ;
  • Lee, Hyo-Jin (Department of Clinical Laboratory Science, College of Health Sciences, Catholic University of Pusan) ;
  • Park, Gyu-Nam (Department of Clinical Laboratory Science, College of Health Sciences, Catholic University of Pusan) ;
  • Kim, Min-Ju (Department of Clinical Laboratory Science, College of Health Sciences, Catholic University of Pusan) ;
  • An, Dong-Jun (National Veterinary Research and Quarantine Service) ;
  • Chang, Kyung-Soo (Department of Clinical Laboratory Science, College of Health Sciences, Catholic University of Pusan)
  • Received : 2012.12.21
  • Accepted : 2012.03.25
  • Published : 2012.03.31

Abstract

Vancomycin-resistant (VR)-E. faecium and VR-E. faecalis were isolated simultaneously from a rectal swab of a patient diagnosed with pneumonia in an intensive care unit (ICU). The patient was treated with various antibiotics including vancomycin. Only VR-E. faecium was continually isolated from the rectal swab at one and two weeks of the treatment. Identical vanA, IS1216V, and IS1542 genes were detected in both VR-E. faecium and VR-E. faecalis isolates which showed equal resistance against vancomycin and teicoplanin, but IS1251 was not detected. VR-E. faecium showed stronger multi-drug resistance than VE-E. faecalis. This result supports the reason why VR-E. faecium is one of the major pathogens in nosocomial infections.

Keywords

References

  1. Kim HJ, Kwon HY, Kim KL, Lee HJ, Jo HJ, Hwang SM, Chang KS. Characterization of vancomycin-resistant enterococci isolated from stools and their acquisition of vancomycin resistance. J Bacteriol and Virol. 2010. 40: 179-189.
  2. Leclercq R, Derlot E, Duval J, Courvalin P. Plasmid-mediated resistance to vancomycin and teicoplanin in Enterococcus faecium. N Engl J Med. 1988. 319: 157-161.
  3. Leclercq R, Derlot E, Weber M, Duval J, Courvalin P. Transferable vancomycin and teicoplanin resistance in Enterococcus faecium. Antimicrob Agents Chemother. 1989. 33: 10-15.
  4. Livornese Jr. LL, Dias S, Samel C, Romanowski B, Taylor S, May P, Pitsakis P, Woods G, Kaye D, Levison ME. Hospitalacquired infection with vancomycin-resistant Enterococcus faecium transmitted by electronic thermometers. Ann Intern Med. 1992. 117: 112-116.
  5. Murray BE, Singh KV, Markowitz SM, Lopardo HA, Patterson JE, Zervos MJ, Rubeglio E, Eliopoulos GM, Rice LB, Goldstein FW. Evidence for clonal spread of a single strain of ${\beta}-lactamase-producing$ Enterococcus faecalis to six hospital in five states. J Infect Dis. 1991. 163: 780-785.
  6. Murray BE, Lopardo HA, Rubeglio EA, Frosolono M, Singh KV. Intrahospital spread of single gentamicin-resistant, ${\beta}-lactamase-producing$ Enterococcus faecalis in Argentina. Antimicrob Agents Chemother. 1992. 36: 230-232.
  7. Noble WC, Virani Z, Cree RG. Co-transfer of vancomycin and other resistance genes from Enterococcus faecalis NCTC 12201 to Staphylococcus aureus. FEMS Microbiol Lett. 1992. 72: 195-198.
  8. Ostrowsky BE, Venkataraman L, D'Agata EM, Gold HS, DeGirolami PC, Samore MH. Vancomycin-resistant enterococci in intensive care units: high frequency of stool carriage during a non-outbreak period. Arch Intern Med. 1999. 159: 1467-1472.
  9. Schaberg DR, Culver DH, Gaynes RP. Major trends in the microbial etiology of nosocomial infection. Am J Med. 1991. 91: 72-75.
  10. Uttley AH, Collins CH, Naidoo J, George RC. Vancomycinresistant enterococci. Lancet. 1988. 1: 57-58.
  11. Xu HT, Tian R, Chen DK, Xiao F, Nie ZY, Hu YJ, Zhang XZ, Li JM. Nosocomial spread of hospital-adapted CC17 vancomycinresistant Enterococcus faecium in a tertiary-care hospital of Beijing, China. Chin Med J. 2011. 124: 498-503.
  12. Yamakawa K, Tasaki O, Fukuyama M, Kitayama J, Matsuda H, Nakamori Y, Fujimi S, Ogura H, Kuwagata Y, Hamasaki T, Shimazu T. Assessment of risk factors related to healthcareassociated methicillin-resistant Staphylococcus aureus infection at patient admission to an intensive care unit in Japan. BMC Infect Dis. 2011. 11: 303.
  13. Zhanel GG, DeCorby M, Laing N, Weshnoweski B, Vashisht R, Tailor F, Nichol KA, Wierzbowski A, Baudry PJ, Karlowsky JA, Lagacé-Wiens P, Walkty A, McCracken M, Mulvey MR, Johnson J, Hoban DJ. Antimicrobial-resistant pathogens in intensive care units in Canada: results of the Canadian National Intensive Care Unit (CAN-ICU) study, 2005-2006. Antimicrob Agents Chemother. 2008. 52: 1430-1437.