Ecological replacement of Enterococcus faecalis by multiresistant clonal complex 17 Enterococcus faecium.
- 2007-03
- Clinical Microbiology and Infection 13(3)
- J. Top
- Rob J. L. Willems
- H. Blok
- M. D. Regt
- K. Jalink
- A. Troelstra
- B. Goorhuis
- M. Bonten
- PubMed: 17391388
- DOI: 10.1111/J.1469-0691.2006.01631.X
Study Design
- Methods
- Epidemiological analysis
- Highly Cited
Abstract
The proportion of enterococcal infections caused by ampicillin-resistant Enterococcus faecium (AREfm) in a European hospital increased from 2% in 1994 to 32% in 2005, with prevalence rates of AREfm endemicity of up to 35% in at least six hospital wards. Diabetes mellitus, three or more admissions in the preceding year, and use of beta-lactams and fluoroquinolones, were all associated with AREfm colonisation. Of 217 AREfm isolates that were genotyped, 97% belonged to clonal complex 17 (CC17). This ecological change mimics events preceding the emergence of vancomycin-resistant E. faecium (VREF) in the USA and may presage the emergence of CC17 VREF in European hospitals.