Nosocomial outbreak due to enterococcus faecium highly resistant to vancomycin, penicillin, and gentamicin

Sandra Handwerger, Beth Raucher, David Altarac, Jean Monka, Susan Marchione, Kavindra V. Singh, Barbara E. Murray, John Wolff, Brian Walters

Research output: Contribution to journalArticlepeer-review

374 Scopus citations

Abstract

In October 1990, Enterococcus faecium that was highly resistant to glycopeptides, penicillins, and aminoglycosides was isolated from the peritoneal dialysis fluid from a patient in an intensive care unit. Over the following 6 months, multiresistant E. faecium organisms were isolated from cultures of blood, urine, or surgical wound specimens from eight additional patients. Surveillance cultures of groin and/or rectal swabs were positive for eight of 37 patients and four of 62 employees at risk. Restriction endonuclease digestion of chromosomal DNA from outbreak isolates was consistent with dissemination of a single strain throughout the intensive care unit. Strict infection control interventions contained the outbreak after several weeks. Review of patient charts suggested that renal insufficiency, length of hospital stay, duration of antibiotic treatment, and prior treatment with vancomycin were risks for infection due to multiresistant E. faecium. The emergence of multiple-drug-resistant enterococci presents serious infection control and therapeutic dilemmas.

Original languageEnglish
Pages (from-to)750-755
Number of pages6
JournalClinical Infectious Diseases
Volume16
Issue number6
DOIs
StatePublished - Jun 1993

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