Emergence and nosocomial transmission of ampicillin-resistant enterococci.

Abstract:

:Between 1986 and 1988, the incidence of ampicillin-resistant enterococci increased sevenfold at a university-affiliated hospital. Forty-three patients acquired nosocomial infections with ampicillin-resistant enterococci, most of which were also resistant to mezlocillin, piperacillin, and imipenem. An analysis of plasmid and chromosomal DNAs of isolates revealed that the increase was due to an epidemic of 19 nosocomial infections that yielded closely related strains of Enterococcus faecium and to a significant increase in the incidence of nonepidemic, largely unrelated strains of ampicillin-resistant enterococci. The nonepidemic strains were identified as E. faecium, E. raffinosus, E. durans, and E. gallinarum. A logistic regression analysis revealed that patients with nonepidemic resistant strains were 16 times more likely than controls to have received preceding therapy with imipenem. In our institution, the increase in the incidence of ampicillin-resistant enterococci appears to be due to the selection of various strains of resistant enterococci by the use of imipenem and to the nosocomial transmission of E. faecium and E. raffinosus.

authors

Boyce JM,Opal SM,Potter-Bynoe G,LaForge RG,Zervos MJ,Furtado G,Victor G,Medeiros AA

doi

10.1128/aac.36.5.1032

subject

Has Abstract

pub_date

1992-05-01 00:00:00

pages

1032-9

issue

5

eissn

0066-4804

issn

1098-6596

journal_volume

36

pub_type

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