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Journal of Clinical Microbiology, June 2002, p. 2084-2088, Vol. 40, No. 6
0095-1137/02/$04.00+0     DOI: 10.1128/JCM.40.6.2084-2088.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Frequent Transmission of Enterococcal Strains between Mechanically Ventilated Patients Treated at an Intensive Care Unit

Bodil Lund,1,2 Christina Agvald-Öhman,1,3 Anna Hultberg,1,2,{dagger} and Charlotta Edlund1,2*

Division of Clinical Bacteriology,1 Division of Anesthesiology and Intensive Care, Huddinge University Hospital, Karolinska Institutet,3 Södertörns Högskola University College, Stockholm, Sweden2

Received 26 December 2001/ Returned for modification 24 January 2002/ Accepted 25 March 2002

The objectives of this investigation were to study the respiratory tract colonization and transmission of enterococci between 20 patients treated with mechanical ventilation at an intensive care unit (ICU), to compare genotyping with phenotyping, and to determine the antibiotic susceptibilities of the isolated enterococci. Samples were collected from the oropharynx, stomach, subglottic space, and trachea within 24 h of intubation, every third day until day 18, and thereafter every fifth day until day 33. Enterococcal isolates (n = 170) were analyzed by pulsed-field gel electrophoresis and with the PhenePlate (PhP) system. The antimicrobial susceptibilities to five agents were determined. Seventeen of the 20 subjects were colonized with enterococci in the respiratory tract; 12 were colonized in the lower respiratory tract. Genotype analyses suggested that 13 patients were involved in a transmission event, including all patients intubated more than 12 days. In conclusion, colonization of resistant enterococci in the respiratory tract of intubated patients treated at an ICU was common. Transmission of enterococci between patients occurred frequently. Prolonged intubation period seems to be a risk factor for enterococcal cross-transmission.

* Corresponding author. Mailing address: Division of Clinical Bacteriology, F82, Huddinge University Hospital, SE-141 86 Stockholm, Sweden. Phone: 46-8-5858 11 39. Fax: 46-8-711 39 18. E-mail: charlotta.edlund{at}impi.ki.se.

{dagger} Present address: Center of Oral Biology, Karolinska Institutet, Stockholm, Sweden.

Journal of Clinical Microbiology, June 2002, p. 2084-2088, Vol. 40, No. 6
0095-1137/02/$04.00+0     DOI: 10.1128/JCM.40.6.2084-2088.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.



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