Journal Article

Dissemination of vancomycin-resistant enterococci among haemodialysis patients in Athens, Greece

Petros Kalocheretis, Eleftheria Baimakou, Sinodi Zerbala, Joseph Papaparaskevas, Ioanna Makriniotou, Panayotis T. Tassios, Christos Iatrou, Evangelia Kouskouni and Loukia Zerva

in Journal of Antimicrobial Chemotherapy

Published on behalf of British Society for Antimicrobial Chemotherapy

Volume 54, issue 6, pages 1031-1034
Published in print December 2004 | ISSN: 0305-7453
Published online December 2004 | e-ISSN: 1460-2091 | DOI:
Dissemination of vancomycin-resistant enterococci among haemodialysis patients in Athens, Greece

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  • Medical Oncology
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Objectives: Vancomycin-resistant enterococci (VRE) may colonize haemodialysis patients, but their epidemiology in this population is not well defined. Within the few last years, VRE strains have emerged and are increasingly isolated in the nosocomial environment in Greece, but colonization of dialysis patients has never been evaluated before. This study sought to determine the epidemiology of VRE colonization within this high-risk population and define the risk factors.

Materials and methods: During a 4 month period, rectal swabs or faecal specimens were collected from 334 consecutive outpatients, who were treated at four independent dialysis units located in the same area of Athens and referring patients to the same local hospital. The relatedness of isolates was defined by molecular typing, and demographic and clinical patient data were recorded.

Results: Thirteen multiresistant Enterococcus faecium vanA strains were isolated corresponding to a colonization frequency of 3.9%. They were separated into seven clusters: type A (two strains), type B (six strains) and types C to G (one strain each). Type B strains originated from three units, while a single unit demonstrated four type B and two type A strains. Univariate statistical analysis revealed that prior hospitalization (P=0.001), prior administration of antimicrobials (P=0.026) and male gender (P=0.019) were associated with VRE colonization.

Conclusions: In Greece, haemodialysis patients are colonized with VRE at a low frequency. The predominance of one clone and its isolation from several units strongly indicate interfacility transmission of strains, most probably within a health care environment shared by all patients.

Keywords: epidemiology; colonization; surveillance cultures

Journal Article.  2406 words.  Illustrated.

Subjects: Medical Oncology ; Critical Care

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