Journal Article

An Outbreak of Vancomycin-Dependent <i>Enterococcus faecium</i> in a Bone Marrow Transplant Unit

B. D. Kirkpatrick, S. M. Harrington, D. Smith, D. Marcellus, C. Miller, J. Dick, L. Karanfil and T. M. Perl

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 29, issue 5, pages 1268-1273
Published in print November 1999 | ISSN: 1058-4838
Published online November 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/313456
An Outbreak of Vancomycin-Dependent Enterococcus faecium in a Bone Marrow Transplant Unit

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Outbreaks of vancomycin-resistant enterococci (VRE) are well described. The presence of mutants of VRE, such as vancomycin-dependent enterococci (VDE), in individual patients has been documented, but their potential to spread nosocomially has not been known. We present the first cluster of patients who acquired VDE nosocomially. Five bone marrow transplantation patients were infected or colonized by a genotypically indistinguishable multiantibiotic-resistant strain of Enterococcus faecium. Vancomycin dependence in 3 of the 5 isolates was demonstrated. All cluster patients had received protracted prophylactic treatment with vancomycin (mean, 22.6 days), and specimens from ⩾2 body sites were repeatedly culture-positive for the outbreak strain. The outbreak was controlled with aggressive infection control strategies, and prophylactic antibiotic policies were revised. Awareness of the potential for nosocomial spread of multiantibiotic-resistant VDE is vital for the care of immunocompromised patients, especially those receiving prophylactic antibiotics.

Journal Article.  3733 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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