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An investigation of vancomycin-resistant Enterococcus faecium within the pediatric service of a large urban medical center
- Source :
- The Pediatric infectious disease journal. 17(3)
- Publication Year :
- 1998
-
Abstract
- Background Between 1990 to 1992 and 1993 to 1995 there was a >5-fold increase (16.7% to 89.8%) in vancomycin-resistant Enterococcus faecium isolates as a percentage of all isolates of vancomycin-resistant enterococci on the pediatric units of The New York Hospital-Cornell Medical Center (NYH-CMC). A molecular epidemiologic investigation was undertaken to determine the extent to which this increase was associated with the spread of a vanA-containing clone of vancomycin-resistant E. faecium that had been previously defined in adults hospitalized at NYH-CMC or with the spread of another vanA clone that had been defined in children hospitalized on the pediatric service at Memorial Sloan-Kettering Cancer Center, which shares a common pediatric intensive care unit and pediatric house staff with NYH-CMC. Methods. Molecular genotyping of vancomycin-resistant E. faecium isolates obtained from pediatric patients from 1993 to 1995 was performed by pulsed field gel electrophoresis of chromosomal SmaI digests. Southern hybridization was performed using vanA- and vanB-specific probes. Medical records of patients were reviewed for pertinent clinical and demographic information. Results. A single vanB clone of vancomycin-resistant E. faecium was responsible for 17 (77.3%) of 22 isolates in the neonatal intensive care unit (NICU) of NYH-CMC. Two other vanB strains of vancomycin-resistant E. faecium and 2 vanA strains were identified among the 5 remaining NICU isolates. Vancomycin-resistant E. faecium isolates from the other pediatric units represented a heterogeneous population of primarily vanA strains, but vanA clonal strains previously identified from patients on adult services at NYH-CMC and from children hospitalized at Memorial Sloan-Kettering Cancer Center were not detected. Conclusion. A newly identified vanB clone was responsible for the increase in vancomycin-resistant E. faecium isolates in the NICU of NYH-CMC. The increase of vancomycin-resistant E. faecium among children hospitalized at NYH-CMC was unrelated to the spread of vancomycin-resistant E. faecium among adults in the same hospital or among children at an affiliated facility cared for by the same house staff and sharing a common pediatric intensive care unit.
- Subjects :
- Microbiology (medical)
DNA, Bacterial
medicine.medical_specialty
Pediatrics
Neonatal intensive care unit
Adolescent
Enterococcus faecium
Intensive Care Units, Pediatric
SmaI
Vancomycin
Intensive Care Units, Neonatal
Epidemiology
Genotype
Pulsed-field gel electrophoresis
Medicine
Humans
Typing
Child
Gram-Positive Bacterial Infections
Pediatric intensive care unit
Cross Infection
biology
business.industry
Infant, Newborn
Infant
Drug Resistance, Microbial
biochemical phenomena, metabolism, and nutrition
biology.organism_classification
Anti-Bacterial Agents
Electrophoresis, Gel, Pulsed-Field
Infectious Diseases
Child, Preschool
Pediatrics, Perinatology and Child Health
bacteria
business
Subjects
Details
- ISSN :
- 08913668
- Volume :
- 17
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- The Pediatric infectious disease journal
- Accession number :
- edsair.doi.dedup.....3982204018e1cbcb16248c924b3bb05d