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A 1.5 Hour Procedure for Identification of Enterococcus Species Directly from Blood Cultures
05:02

A 1.5 Hour Procedure for Identification of Enterococcus Species Directly from Blood Cultures

Published on: February 10, 2011

Ecological replacement of Enterococcus faecalis by multiresistant clonal complex 17 Enterococcus faecium

J Top1, R Willems, H Blok

  • 1Eijkman-Winkler Institute for Microbiology, Infectious Diseases and Inflammation, University Medical Centre Utrecht, Utrecht, The Netherlands. j.top@umcutrecht.nl

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
|March 30, 2007
PubMed

Insights

Ampicillin-resistant Enterococcus faecium (AREfm) infections surged in a European hospital, rising from 2% to 32% between 1994 and 2005. Most AREfm isolates belonged to clonal complex 17 (CC17), raising concerns for future vancomycin-resistant E. faecium (VREF) emergence.

Area of Science:

  • Clinical Microbiology
  • Infectious Diseases
  • Epidemiology

Background:

  • Enterococcal infections pose a significant healthcare challenge.
  • The rise of antibiotic resistance in Enterococcus faecium is a growing concern.
  • Ampicillin resistance in Enterococcus faecium (AREfm) has been observed in European hospitals.

Purpose of the Study:

  • To investigate the epidemiological trends of ampicillin-resistant Enterococcus faecium (AREfm) in a European hospital.
  • To identify risk factors associated with AREfm colonization.
  • To determine the genetic relatedness of AREfm isolates and assess potential future resistance emergence.

Main Methods:

  • Retrospective analysis of AREfm infection data from 1994 to 2005.
  • Multivariate analysis to identify risk factors for AREfm colonization.
  • Genotyping of AREfm isolates using established methods.

Main Results:

  • The proportion of AREfm infections increased from 2% in 1994 to 32% in 2005.
  • Prevalence rates of AREfm reached up to 35% in several hospital wards.
  • Diabetes mellitus, multiple prior admissions, and use of beta-lactams and fluoroquinolones were associated with AREfm colonization.
  • 97% of genotyped AREfm isolates belonged to clonal complex 17 (CC17).

Conclusions:

  • A significant increase in ampicillin-resistant Enterococcus faecium (AREfm) has been observed in this European hospital.
  • Specific patient factors and antibiotic exposures are linked to AREfm colonization.
  • The dominance of clonal complex 17 (CC17) in AREfm isolates may foreshadow the emergence of vancomycin-resistant E. faecium (VREF) in European healthcare settings.

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