This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints and Permissions Copyright Information Books from ASM Press MicrobeWorld Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bodnar, U. R. Articles by Peterson, L. R. Search for Related Content PubMed PubMed Citation Articles by Bodnar, U. R. Articles by Peterson, L. R.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, Sep 1996, 2129-2132, Vol 34, No. 9
Copyright © 1996 by the American Society for Microbiology. All rights reserved.

Use of in-house studies of molecular epidemiology and full species identification for controlling spread of vancomycin-resistant Enterococcus faecalis isolates

UR Bodnar, GA Noskin, T Suriano, I Cooper, BE Reisberg and LR Peterson
Department of Medicine, Northwestern, Memorial Hospital, Chicago, Illinois 60611, USA.

Infection with multidrug-resistant (MDR) organisms is a major clinical challenge, and few, if any, therapeutic options remain available. Increasingly, infection control measures have taken on greater importance in preventing the nosocomial transmission of MDR organisms. During December 1994 and January 1995, we identified a cluster of vancomycin-resistant Enterococcus faecalis isolates involving 16 patients situated in different areas of our university-affiliated teaching hospital. Initial review of laboratory requisition forms for the patients' locations revealed no common association, suggesting that the occurrence was not due to horizontal spread. However, using genomic DNA extraction, restriction enzyme analysis, and gel electrophoresis, we found that 12 patients were infected with isolates originating from a single clone, 2 other patients were infected with isolates from a different clone, and the remaining 2 patients were infected with unique strains. Because the typing data suggested nosocomial spread, chart review was undertaken to determine a possible common exposure source. With three exceptions, clonal isolates were linked to patient movement between surgical floors, intensive care units, and a rehabilitation unit. A detailed review of patient records revealing the association would not have been performed without realization of clonality. Thus, the data demonstrate the utility of genomic typing for epidemiological purposes. In turn, targeted infection control measures that halted the spread of the potentially lethal MDR pathogen were instituted.

This article has been cited by other articles:

• Singh, A., Goering, R. V., Simjee, S., Foley, S. L., Zervos, M. J. (2006). Application of Molecular Techniques to the Study of Hospital Infection. Clin. Microbiol. Rev. 19: 512-530 [Abstract] [Full Text]  
• Peterson, L. R., Brossette, S. E. (2002). Hunting Health Care-Associated Infections from the Clinical Microbiology Laboratory: Passive, Active, and Virtual Surveillance. J. Clin. Microbiol. 40: 1-4 [Full Text]  
• Kirschner, C., Maquelin, K., Pina, P., Ngo Thi, N. A., Choo-Smith, L.-P., Sockalingum, G. D., Sandt, C., Ami, D., Orsini, F., Doglia, S. M., Allouch, P., Mainfait, M., Puppels, G. J., Naumann, D. (2001). Classification and Identification of Enterococci: a Comparative Phenotypic, Genotypic, and Vibrational Spectroscopic Study. J. Clin. Microbiol. 39: 1763-1770 [Abstract] [Full Text]  
• Savor, C., Pfaller, M. A., Kruszynski, J. A., Hollis, R. J., Noskin, G. A., Peterson, L. R. (1998). Comparison of Genomic Methods for Differentiating Strains of Enterococcus faecium: Assessment Using Clinical Epidemiologic Data. J. Clin. Microbiol. 36: 3327-3331 [Abstract] [Full Text]  
• Klein, G., Pack, A., Reuter, G. (1998). Antibiotic Resistance Patterns of Enterococci and Occurrence of Vancomycin-Resistant Enterococci in Raw Minced Beef and Pork in Germany. Appl. Environ. Microbiol. 64: 1825-1830 [Abstract] [Full Text]  
• Stosor, V., Peterson, L. R., Postelnick, M., Noskin, G. A. (1998). Enterococcus faecium Bacteremia: Does Vancomycin Resistance Make a Difference?. Arch Intern Med 158: 522-527 [Abstract] [Full Text]