An investigation of vancomycin-resistant Enterococcus faecium within the pediatric service of a large urban medical center Journal Article
| Authors: | McNeeley, D. F.; Brown, A. E.; Noel, G. J.; Chung, M.; De Lencastre, H. |
| Article Title: | An investigation of vancomycin-resistant Enterococcus faecium within the pediatric service of a large urban medical center |
| 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 vices 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. |
| Keywords: | adolescent; child; child, preschool; major clinical study; hospitalization; antibiotic resistance; anti-bacterial agents; infant; infant, newborn; newborn; vancomycin resistance; gram-positive bacterial infections; vancomycin; university hospital; bacterium culture; dna, bacterial; cross infection; bacterium isolation; pulsed field gel electrophoresis; electrophoresis, gel, pulsed-field; intensive care units, pediatric; enterococcus faecium; clone; southern blotting; hospital department; drug resistance, microbial; enterococcus faecalis; nosocomial infections; humans; human; male; female; priority journal; article; newborn intensive care; intensive care units, neonatal |
| Journal Title: | Pediatric Infectious Disease Journal |
| Volume: | 17 |
| Issue: | 3 |
| ISSN: | 0891-3668 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 1998-03-01 |
| Start Page: | 184 |
| End Page: | 188 |
| Language: | English |
| DOI: | 10.1097/00006454-199803000-00003 |
| PUBMED: | 9535243 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 12 December 2016 -- Source: Scopus |
