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25- to 30-nm virus particle associated with a hospital outbreak of acute gastroenteritis with evidence for airborne transmission.

https://arctichealth.org/en/permalink/ahliterature233035
Source
Am J Epidemiol. 1988 Jun;127(6):1261-71
Publication Type
Article
Date
Jun-1988
Author
L A Sawyer
J J Murphy
J E Kaplan
P F Pinsky
D. Chacon
S. Walmsley
L B Schonberger
A. Phillips
K. Forward
C. Goldman
Author Affiliation
Division of Viral Diseases, Centers for Disease Control, Atlanta, GA 30333.
Source
Am J Epidemiol. 1988 Jun;127(6):1261-71
Date
Jun-1988
Language
English
Publication Type
Article
Keywords
Adult
Air Microbiology
Cross Infection - epidemiology - microbiology - transmission
Disease Outbreaks
Emergency Service, Hospital
Epidemiologic Methods
Female
Gastroenteritis - epidemiology - microbiology - transmission
Hospital Units
Humans
Male
Middle Aged
Norwalk virus - isolation & purification
Ontario
Virion - isolation & purification
Virus Diseases - epidemiology - transmission
Abstract
Between November 1 and 22, 1985, an outbreak of acute, nonbacterial gastroenteritis occurred in a 600-bed hospital in Toronto, Ontario, Canada. Illness in 635 of 2,379 (27%) staff was characterized by fatigue, nausea, diarrhea, and vomiting and had a median duration of 24-48 hours. The finding of virus-like particles measuring 25-30 nm in six stool specimens and low rates of seroresponse to Norwalk virus (3/39) and Snow Mountain agent (1/6) suggest that a Norwalk-like virus was responsible for the outbreak. The outbreak was of abrupt onset and high incidence, affecting 79 people in a single day. No common food or water exposure could be identified. The attack rate was greatest (69%) for staff who had worked in the Emergency Room. Of 100 patients and their companions who visited the Emergency Room on November 11-12 for unrelated problems, 33 (33%) developed gastroenteritis 24-48 hours after their visit, versus 0 of 18 who visited the Emergency Room on November 8 (p less than 0.001). An analysis of housekeepers who worked at least once during the period from November 9-13, which included those who became ill during the period of November 9-14, showed that the risk of becoming ill was four times greater for those who visited or walked through the Emergency Room than for those who did not (p = 0.028). These data are consistent with the possibility of the airborne spread of a virus.
PubMed ID
2835899 View in PubMed
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Ampicillin-resistant enterococci in a Swedish university hospital: nosocomial spread and risk factors for infection.

https://arctichealth.org/en/permalink/ahliterature195013
Source
Scand J Infect Dis. 2001;33(3):182-7
Publication Type
Article
Date
2001
Author
E. Torell
O. Cars
A. Hambraeus
Author Affiliation
Department of Medical Sciences, Uppsala University Hospital, Sweden.
Source
Scand J Infect Dis. 2001;33(3):182-7
Date
2001
Language
English
Publication Type
Article
Keywords
Ampicillin Resistance
Anti-Bacterial Agents - therapeutic use
Carrier State - epidemiology - microbiology - transmission
Case-Control Studies
Cross Infection - epidemiology - microbiology - transmission
Drug Resistance, Microbial
Electrophoresis, Gel, Pulsed-Field
Enterococcus - classification - drug effects - isolation & purification
Feces - microbiology
Female
Gram-Positive Bacterial Infections - epidemiology - microbiology - transmission
Humans
Incidence
Infection Control
Longevity
Male
Odds Ratio
Risk factors
Sweden - epidemiology
Time Factors
Abstract
Ampicillin-resistant enterococci (ARE) have recently emerged as clinical pathogens in Sweden. Between 1991 and 1995 the incidence of ARE among enterococcal isolates at Uppsala University Hospital increased from 0.5% to 8.1%. Shedding of ARE from infected cases and risk factors for infection with ARE were studied during a period of 7 months for 38 ARE cases and 38 controls with ampicillin-susceptible enterococci. ARE cases had longer mean duration of hospitalization than controls (29 d vs. 15 d; p = 0.002). In univariate analysis other risk factors for infection with ARE were found to be prior therapy with > 2 antimicrobials (odds ratio [OR] 3.3; 95% confidence interval [CI] 1.2-9.5), > 4 weeks of antimicrobial therapy (OR 6.9; CI 1.8-28.3) and cephalosporin therapy (OR 9.1; CI 2.6-33.7). Fourteen of 26 skin carriers of ARE were found to be shedding ARE to the environment, compared to 2 of 12 non-skin carriers (p = 0.03). Pulsed-field gel electrophoresis suggested multifocal origin of the majority of the infecting ARE strains. Non-recognized fecal colonization and silent spread of ARE among many patients and over a prolonged time period is suggested to be the main explanation for the increase of ARE infections in our hospital. Infection control measures focusing on protecting patients at high risk for ARE infections and further efforts to optimize antimicrobial use are proposed.
PubMed ID
11303807 View in PubMed
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Community spread of Legionella pneumophila serogroup 1 in temporal relation to a nosocomial outbreak.

https://arctichealth.org/en/permalink/ahliterature195012
Source
Scand J Infect Dis. 2001;33(3):194-9
Publication Type
Article
Date
2001
Author
J. Darelid
H. Hallander
S. Löfgren
B E Malmvall
A M Olinder-Nielsen
Author Affiliation
Department of Infectious Diseases, Ryhov Hospital, Jönköping, Sweden.
Source
Scand J Infect Dis. 2001;33(3):194-9
Date
2001
Language
English
Publication Type
Article
Keywords
Adult
Antibodies, Bacterial - blood
Community-Acquired Infections - epidemiology - microbiology - transmission
Cross Infection - epidemiology - microbiology - transmission
Disease Outbreaks
Female
Humans
Legionella pneumophila - classification - immunology - isolation & purification
Legionnaires' Disease - epidemiology - microbiology - transmission
Male
Nurses' Aides
Occupational Diseases - epidemiology - microbiology
Seasons
Seroepidemiologic Studies
Serotyping
Sweden - epidemiology
Water Microbiology
Water supply
Abstract
To clarify whether a nosocomial outbreak of legionnaires' disease in the Värnamo hospital in Sweden was part of a wider outbreak in the Värnamo community a number of investigations were performed. First, the proportion of cases of legionnaires' disease in a group with nosocomially acquired pneumonia (11%) was compared to the proportion within a group with community-acquired pneumonia (14%) and the difference was found not to be significant (p > 0.05). Second, the proportion of the nursing staff at the Värnamo hospital with an elevated antibody titre (> or = 16) to Legionella pneumophila serogroup (sg) 1 (33%, 84/258) was compared to the proportion in a group of local residents of Värnamo community (26%, 25/96) and found not to be significant; in contrast, comparison with the proportion in a group from the assistant nursing staff at another hospital 60 km away (5%, 4/80) was highly significant (p
PubMed ID
11303809 View in PubMed
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The effect of hospital-acquired infection with Clostridium difficile on length of stay in hospital.

https://arctichealth.org/en/permalink/ahliterature129091
Source
CMAJ. 2012 Jan 10;184(1):37-42
Publication Type
Article
Date
Jan-10-2012
Author
Alan J Forster
Monica Taljaard
Natalie Oake
Kumanan Wilson
Virginia Roth
Carl van Walraven
Author Affiliation
Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. aforster@ohri.ca
Source
CMAJ. 2012 Jan 10;184(1):37-42
Date
Jan-10-2012
Language
English
Publication Type
Article
Keywords
Aged
Clostridium difficile - isolation & purification
Cross Infection - epidemiology - microbiology - transmission
Enterocolitis, Pseudomembranous - epidemiology - microbiology - transmission
Female
Hospital Mortality - trends
Humans
Incidence
Length of Stay - trends
Male
Middle Aged
Ontario - epidemiology
Retrospective Studies
Risk factors
Abstract
The effect of hospital-acquired infection with Clostridium difficile on length of stay in hospital is not yet fully understood. We determined the independent impact of hospital-acquired infection with C. difficile on length of stay in hospital.
We conducted a retrospective observational cohort study of admissions to hospital between July 1, 2002, and Mar. 31, 2009, at a single academic hospital. We measured the association between infection with hospital-acquired C. difficile and time to discharge from hospital using Kaplan-Meier methods and a Cox multivariable proportional hazards regression model. We controlled for baseline risk of death and accounted for C. difficile as a time-varying effect.
Hospital-acquired infection with C. difficile was identified in 1393 of 136,877 admissions to hospital (overall risk 1.02%, 95% confidence interval [CI] 0.97%-1.06%). The crude median length of stay in hospital was greater for patients with hospital-acquired C. difficile (34 d) than for those without C. difficile (8 d). Survival analysis showed that hospital-acquired infection with C. difficile increased the median length of stay in hospital by six days. In adjusted analyses, hospital-acquired C. difficile was significantly associated with time to discharge, modified by baseline risk of death and time to acquisition of C. difficile. The hazard ratio for discharge by day 7 among patients with hospital-acquired C. difficile was 0.55 (95% CI 0.39-0.70) for patients in the lowest decile of baseline risk of death and 0.45 (95% CI 0.32-0.58) for those in the highest decile; for discharge by day 28, the corresponding hazard ratios were 0.74 (95% CI 0.60-0.87) and 0.61 (95% CI 0.53-0.68).
Hospital-acquired infection with C. difficile significantly prolonged length of stay in hospital independent of baseline risk of death.
Notes
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Cites: J Hosp Infect. 2008 Sep;70(1):15-2018602185
Cites: J Clin Microbiol. 2010 Feb;48(2):606-820032256
Cites: J Hosp Infect. 2010 Apr;74(4):309-1820153547
Cites: J Clin Epidemiol. 2010 Jul;63(7):798-80320004550
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Cites: J Clin Epidemiol. 2004 Jul;57(7):672-8215358395
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Cites: J Hosp Infect. 1996 Sep;34(1):23-308880547
Cites: Annu Rev Public Health. 1999;20:145-5710352854
Cites: Med Care. 2005 Nov;43(11):1130-916224307
Cites: CMAJ. 2005 Oct 25;173(9):1037-4216179431
Cites: Infect Control Hosp Epidemiol. 2007 Feb;28(2):140-517265394
Cites: Med Care. 2008 Mar;46(3):232-918388836
Comment In: CMAJ. 2012 Jan 10;184(1):17-822143231
PubMed ID
22143235 View in PubMed
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Epidemic outbreaks of acute pyelonephritis caused by nosocomial spread of P fimbriated Escherichia coli in children.

https://arctichealth.org/en/permalink/ahliterature39746
Source
J Infect Dis. 1984 Nov;150(5):728-36
Publication Type
Article
Date
Nov-1984
Author
K. Tullus
K. Hörlin
S B Svenson
G. Källenius
Source
J Infect Dis. 1984 Nov;150(5):728-36
Date
Nov-1984
Language
English
Publication Type
Article
Keywords
Acute Disease
Anti-Bacterial Agents - pharmacology
Cross Infection - epidemiology - microbiology - transmission
Disease Outbreaks - epidemiology
Drug Resistance, Microbial
Escherichia coli - drug effects - growth & development - ultrastructure
Escherichia coli Infections - epidemiology - microbiology - transmission
Feces - microbiology
Female
Fimbriae, Bacterial
Hospital Units
Humans
Infant
Infant, Newborn
Male
Personnel, Hospital
Pyelonephritis - epidemiology - microbiology
Research Support, Non-U.S. Gov't
Retrospective Studies
Sweden
Umbilicus - microbiology
Abstract
In a study of pyelonephritis in children less than two years of age we found a high incidence of acute first-time pyelonephritis among children who had been previously cared for in a particular hospital neonatal ward. In 1981 and 1982 more than 50% of the children with pyelonephritis from the referral area of Danderyd Hospital (Danderyd, Sweden) had previously attended this particular neonatal ward; the expected incidence was 15% (P less than .001). The majority of these cases of pyelonephritis were caused by Escherichia coli that were P fimbriated and of serotype O6:K5. An E. coli strain with the same characteristics was found in the stools of personnel in the neonatal ward and in a high proportion of the stools and cord stumps of neonates in the ward. These findings support the opinion that certain P fimbriated E. coli clones may be nosocomially spread and cause epidemic outbreaks of pyelonephritis and that fecal colonization with such E. coli predisposes to this disease.
PubMed ID
6149248 View in PubMed
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Epidemiology of European community-associated methicillin-resistant Staphylococcus aureus clonal complex 80 type IV strains isolated in Denmark from 1993 to 2004.

https://arctichealth.org/en/permalink/ahliterature87264
Source
J Clin Microbiol. 2008 Jan;46(1):62-8
Publication Type
Article
Date
Jan-2008
Author
Larsen A R
Böcher S.
Stegger M.
Goering R.
Pallesen L V
Skov R.
Author Affiliation
Statens Serum Institut, National Center for Antimicrobials and Infection Control, Artillerivej 5 (B.47/204), 2300 Copenhagen S, Denmark. arl@ssi.dk
Source
J Clin Microbiol. 2008 Jan;46(1):62-8
Date
Jan-2008
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents - pharmacology
Child
Child, Preschool
Cross Infection - epidemiology - microbiology - transmission
DNA Fingerprinting
DNA, Bacterial - genetics
Denmark - epidemiology
Electrophoresis, Gel, Pulsed-Field
Family Health
Genotype
Humans
Infant
Infant, Newborn
Methicillin Resistance
Microbial Sensitivity Tests
Middle Aged
Sequence Analysis, DNA
Soft Tissue Infections - epidemiology - microbiology - transmission
Staphylococcal Infections - epidemiology - microbiology - transmission
Staphylococcal Protein A - genetics
Staphylococcal Skin Infections - epidemiology - microbiology - transmission
Staphylococcus aureus - classification - drug effects - genetics - isolation & purification
Travel
Abstract
In Europe, community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections have been caused predominantly by isolates belonging to the "European CA-MRSA" clone (sequence type 80, staphylococcal cassette chromosome mec type IV). In this study, the epidemiology of European CA-MRSA was investigated on a nationwide scale, covering the period from 1993 to 2004. Denmark has been a low-prevalence country regarding MRSA since the mid-1970s but has experienced an increase in the number of new MRSA cases in recent years. Our results show that European CA-MRSA contributed to this increase. The isolates primarily caused skin and soft tissue infections (SSTIs) in patients outside hospitals, and transmission between household members was the predominant mode of spread. Although some of the isolates were found in hospitalized patients, nosocomial transmission seemed likely in only one instance, pointing to endogenous infections as an important factor. Compared to the CA-MRSA clone most common in the United States (USA300), the European CA-MRSA clone seems less well adapted to persist in hospital environments. Patients with a recent history of travel or family relation to the Mediterranean or Middle East were highly overrepresented. The epidemiological data indicated that the European CA-MRSA isolates were introduced into Denmark on multiple occasions, paralleled by an increasing level of genetic diversity of the isolates found during the study period. European CA-MRSA has previously been described as a rather uniform clone. However, we found pronounced, diverse pulsed-field gel electrophoresis subtypes, staphylococcal protein A gene (spa) types, and susceptibility patterns.
PubMed ID
17989197 View in PubMed
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Epidemiology of Pseudomonas aeruginosa in cystic fibrosis in British Columbia, Canada.

https://arctichealth.org/en/permalink/ahliterature188314
Source
Am J Respir Crit Care Med. 2002 Oct 1;166(7):988-93
Publication Type
Article
Date
Oct-1-2002
Author
David P Speert
Maureen E Campbell
Deborah A Henry
Ruth Milner
Fatma Taha
Anna Gravelle
A George F Davidson
Lawrence T K Wong
Eshwar Mahenthiralingam
Author Affiliation
Division of Infectious and Immunological Diseases, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada. speert@interchange.ubc.ca
Source
Am J Respir Crit Care Med. 2002 Oct 1;166(7):988-93
Date
Oct-1-2002
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
British Columbia - epidemiology
Child
Child Welfare
Child, Preschool
Cross Infection - epidemiology - microbiology - transmission
Cystic Fibrosis - epidemiology - microbiology
Disease Outbreaks
Electrophoresis, Gel, Pulsed-Field
Family Health
Humans
Infant
Infant Welfare
Pseudomonas Infections - epidemiology - microbiology - transmission
Pseudomonas aeruginosa - isolation & purification
Abstract
Pseudomonas aeruginosa is the most common respiratory pathogen in patients with cystic fibrosis (CF), but the predominant mechanism by which it is acquired is controversial. To determine the frequency of patient-to-patient spread, we evaluated P. aeruginosa isolates from 174 patients treated at the CF clinics in Vancouver, BC, Canada, since 1981. Multiple isolates were obtained from each patient and genetically typed by random amplified polymorphic DNA and pulsed field gel electrophoresis analyses. A total of 157 genetic types of P. aeruginosa was identified, 123 of which were unique to individual patients. A total of 34 types was shared by more than one patient; epidemiologic evidence linked these individuals only in the cases of 10 sibships and 1 pair of unrelated patients. We conclude that there is an extremely low risk in Vancouver for patients with CF to acquire P. aeruginosa from other patients. It appears that prolonged close contact, such as occurs between siblings, is necessary for patient-to-patient spread. The major source of acquisition of P. aeruginosa in CF appears to be from the environment. Considering these observations, we do not recommend segregation of patients with CF on the basis of their colonization status with P. aeruginosa.
Notes
Comment In: Am J Respir Crit Care Med. 2002 Oct 1;166(7):906-712359642
PubMed ID
12359659 View in PubMed
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Factors associated with acquisition of vancomycin-resistant enterococci (VRE) in roommate contacts of patients colonized or infected with VRE in a tertiary care hospital.

https://arctichealth.org/en/permalink/ahliterature157681
Source
Infect Control Hosp Epidemiol. 2008 May;29(5):398-403
Publication Type
Article
Date
May-2008
Author
Qian Zhou
Christine Moore
Sarah Eden
Agnes Tong
Allison McGeer
Author Affiliation
Department of Public Health Sciences, University of Toronto, Toronto, ON, Canada.
Source
Infect Control Hosp Epidemiol. 2008 May;29(5):398-403
Date
May-2008
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Canada
Cohort Studies
Cross Infection - epidemiology - microbiology - transmission
Enterococcus - drug effects - isolation & purification
Female
Gram-Positive Bacterial Infections - epidemiology - microbiology - transmission
Hospitals, Teaching - statistics & numerical data
Humans
Male
Middle Aged
Prevalence
Risk factors
Vancomycin Resistance
Abstract
Most nosocomial acquistion of vancomycin-resistant enterococci (VRE) is due to cross-transmission. We sought to identify risk factors for acquisition of VRE by roommates of patients colonized or infected with VRE.
Retrospective cohort study.
A 472-bed tertiary care teaching hospital.
All patients who shared a room with a patient colonized or infected with VRE at our hospital between January 1, 1999 and December 31, 2006 were identified. These roommates of VRE-positive patients were screened by rectal swab culture on days 2, 5, and 7 after the last exposure to the index patient. Chart reviews were performed to identify risk factors for VRE colonization in these roommates.
Eighty-eight roommates of patients colonized or infected with VRE were identified. Of the 38 roommates with complete follow-up, 8 (21%) became colonized with VRE. These 8 roommates were older (median, 87.5 vs 62.5 years of age; P = .001), had longer duration of room exposure (median, 8.5 vs 4 days; P = .002), and were more likely to have a urinary catheter (odds ratio [OR], 16 [95% confidence interval {CI}, 1.7-152]; P = .005), an elevated serum creatinine level (OR, 17 [95% CI, 1.4-196]; P = .02), low serum albumin level (OR, 9.9 [95% CI, 1.3-113]; P = .01), and recent third-generation cephalosporin use (OR, 8.3 [95% CI, 1.5-47]; P = .02).
Roommates of patients identified as colonized or infected with VRE are at substantial risk of becoming colonized, with the degree of risk increasing in older and more frail patients. VRE control programs should pay particular attention to such patients.
PubMed ID
18419360 View in PubMed
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Importance of the environment and the faecal flora of infants, nursing staff and parents as sources of gram-negative bacteria colonizing newborns in three neonatal wards.

https://arctichealth.org/en/permalink/ahliterature59586
Source
Infection. 1992 Sep-Oct;20(5):253-7
Publication Type
Article
Author
B. Fryklund
K. Tullus
B. Berglund
L G Burman
Author Affiliation
Dept. of Bacteriology, National Bacteriological Laboratory, Stockholm, Sweden.
Source
Infection. 1992 Sep-Oct;20(5):253-7
Language
English
Publication Type
Article
Keywords
Age Factors
Colony Count, Microbial
Cross Infection - epidemiology - microbiology - transmission
DNA Fingerprinting
Delivery, Obstetric - methods
Disease Reservoirs
Enterobacteriaceae - classification - genetics
Enterobacteriaceae Infections - epidemiology - microbiology - transmission
Environmental Microbiology
Feces - microbiology
Female
Humans
Infant, Newborn
Infection Control
Male
Nurseries, Hospital
Nursing Staff, Hospital
Oropharynx - microbiology
Parents
Phenotype
Prospective Studies
Research Support, Non-U.S. Gov't
Serotyping
Sweden - epidemiology
Umbilicus - microbiology
Abstract
Gram-negative bacteria are an important cause of invasive infection among neonates. In this study a novel fingerprinting method was used for the first time to assess the importance of various potential reservoirs of the major gram-negative enterobacteria that colonized 46 consecutive infants in three neonatal special care units during a three to four week period. Such bacteria were isolated from the oropharynx, umbilical cord and faeces in 24%, 33% and 100% of the infants, respectively. Klebsiella/Enterobacter spp. dominated over Escherichia coli and spreading (shared) over sporadic strains. Sixty-one percent of the neonates were colonized with at least one and up to six different strains shown to exist in the ward, mainly in other infants. Environmental reservoirs and the faecal flora of mothers and staff were of minor importance. Vertical transmission occurred in 12% of vaginally delivered infants and in 0% of those delivered by caesarean section.
PubMed ID
1428181 View in PubMed
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Intrahospital spread of vancomycin-resistant Enterococcus faecium in Sweden.

https://arctichealth.org/en/permalink/ahliterature209997
Source
Scand J Infect Dis. 1997;29(3):259-63
Publication Type
Article
Date
1997
Author
E. Torell
H. Fredlund
E. Törnquist
E B Myhre
L. Sjöberg
A. Sundsfjord
Author Affiliation
Department of Microbiology, University Hospital, Uppsala, Sweden.
Source
Scand J Infect Dis. 1997;29(3):259-63
Date
1997
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Anti-Bacterial Agents - pharmacology
Bacterial Proteins - genetics
Carbon-Oxygen Ligases
Cross Infection - epidemiology - microbiology - transmission
DNA, Bacterial - chemistry - genetics
Disease Outbreaks
Drug Resistance, Microbial
Electrophoresis, Gel, Pulsed-Field
Enterococcus faecium - drug effects - genetics - isolation & purification
Female
Gram-Positive Bacterial Infections - epidemiology - microbiology - transmission
Humans
Ligases - genetics
Male
Middle Aged
Polymerase Chain Reaction
Sweden - epidemiology
Vancomycin - pharmacology
Abstract
During a 17-week period vancomycin-resistant Enterococcus faecium (VRE) was found in clinical specimens from 4 in-patients. All bacterial isolates were phenotypically VanA, showing high-level resistance to vancomycin (MIC 256 micrograms/ml) and teicoplanin (MIC 24-256 micrograms/ml). The corresponding gene (vanA) was detected with PCR in strains from 3 of the patients. Three patients had been hospitalized at the renal unit at Orebro Medical Centre Hospital (OMCH). The fourth patient, diagnosed in another hospital, had received treatment in the oncology unit at OMCH. All patients recovered without treatment specific for VRE. Isolates from 2 patients were indistinguishable by pulsed-field gel electrophoresis of genomic DNA. Genetically, these strains were related to the VRE isolates from the 2 other patients. Screening of hospital staff and other in-patients for gastrointestinal carriage of VRE was negative. Glycopeptide-resistant enterococci have not previously been found in OMCH. No new cases were identified during a 10-month follow-up period. Our cases represent the first nosocomial outbreak of VRE in Sweden.
PubMed ID
9255886 View in PubMed
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16 records – page 1 of 2.