Emergence of ampicillin-resistant Enterococcus faecium in Danish hospitals

Camilla H Lester; Dorthe Sandvang; Stefan Olsen; Henrik Carl Schønheyder; Jens Otto Jarløv; Jette Marie Bangsborg; Dennis S Hansen; Thøger Gorm Jensen; Niels Frimodt-Møller; Anette Marie Hammerum; DANRES Study Group

doi:10.1093/jac/dkn360

Emergence of ampicillin-resistant Enterococcus faecium in Danish hospitals

Camilla H Lester, Dorthe Sandvang, Stefan Olsen, Henrik Carl Schønheyder, Jens Otto Jarløv, Jette Marie Bangsborg, Dennis S Hansen, Thøger Gorm Jensen, Niels Frimodt-Møller, Anette Marie Hammerum, DANRES Study Group

54 Citations (Scopus)

Abstract

BACKGROUND: Ampicillin-resistant Enterococcus faecium isolates are reported in increasing numbers in many European hospitals. The clonal complex 17 (CC17) characterized by ampicillin resistance has been associated with nosocomial E. faecium outbreaks and infections in five continents. The aim was to investigate how prevalent ampicillin resistance is in clinical E. faecium isolates from Denmark and to investigate their clonal affiliation, especially to CC17. METHODS: Microbiology data from 2002 through 2006 on E. faecium and Enterococcus faecalis blood isolates was received from Departments of Clinical Microbiology in 11 Danish counties. From January 2004 through December 2004, we collected 275 clinical enterococci from four of these departments. Multilocus sequence typing (MLST) and PFGE were performed on the 84 ampicillin-resistant E. faecium isolates from this collection. RESULTS: A 68% increase in the number of infections caused by enterococci was observed from 2002 through 2006. The increase was mainly caused by E. faecium isolates, which tripled, whereas the number of E. faecalis isolates increased by only 23% during the same period. There was also a significant increase in the number of ampicillin-resistant E. faecium isolates. MLST showed that 98% of the tested ampicillin-resistant E. faecium isolates belonged to CC17. PFGE showed eight different clusters and we found indications of clonal spread within the hospitals. CONCLUSIONS: Ampicillin-resistant E. faecium isolates have increased in frequency in Denmark during 2002-2006. Most of the ampicillin-resistant E. faecium isolates belong to complex CC17
Udgivelsesdato: 2008/12

Original language	English
Journal	Journal of Antimicrobial Chemotherapy
Volume	62
Issue number	6
Pages (from-to)	1203-1206
Number of pages	4
ISSN	0305-7453
DOIs	https://doi.org/10.1093/jac/dkn360
Publication status	Published - 2008

Keywords

Ampicillin
Ampicillin Resistance
Anti-Bacterial Agents
Bacteremia
Bacterial Typing Techniques
Cluster Analysis
Cross Infection
DNA Fingerprinting
Denmark
Electrophoresis, Gel, Pulsed-Field
Enterococcus faecalis
Enterococcus faecium
Genotype
Gram-Positive Bacterial Infections
Hospitals
Humans
Incidence
Sequence Analysis, DNA

Access to Document

10.1093/jac/dkn360

Cite this

@article{ccf967008d5f11de8bc9000ea68e967b,

title = "Emergence of ampicillin-resistant Enterococcus faecium in Danish hospitals",

abstract = "BACKGROUND: Ampicillin-resistant Enterococcus faecium isolates are reported in increasing numbers in many European hospitals. The clonal complex 17 (CC17) characterized by ampicillin resistance has been associated with nosocomial E. faecium outbreaks and infections in five continents. The aim was to investigate how prevalent ampicillin resistance is in clinical E. faecium isolates from Denmark and to investigate their clonal affiliation, especially to CC17. METHODS: Microbiology data from 2002 through 2006 on E. faecium and Enterococcus faecalis blood isolates was received from Departments of Clinical Microbiology in 11 Danish counties. From January 2004 through December 2004, we collected 275 clinical enterococci from four of these departments. Multilocus sequence typing (MLST) and PFGE were performed on the 84 ampicillin-resistant E. faecium isolates from this collection. RESULTS: A 68% increase in the number of infections caused by enterococci was observed from 2002 through 2006. The increase was mainly caused by E. faecium isolates, which tripled, whereas the number of E. faecalis isolates increased by only 23% during the same period. There was also a significant increase in the number of ampicillin-resistant E. faecium isolates. MLST showed that 98% of the tested ampicillin-resistant E. faecium isolates belonged to CC17. PFGE showed eight different clusters and we found indications of clonal spread within the hospitals. CONCLUSIONS: Ampicillin-resistant E. faecium isolates have increased in frequency in Denmark during 2002-2006. Most of the ampicillin-resistant E. faecium isolates belong to complex CC17 Udgivelsesdato: 2008/12",

keywords = "Ampicillin, Ampicillin Resistance, Anti-Bacterial Agents, Bacteremia, Bacterial Typing Techniques, Cluster Analysis, Cross Infection, DNA Fingerprinting, Denmark, Electrophoresis, Gel, Pulsed-Field, Enterococcus faecalis, Enterococcus faecium, Genotype, Gram-Positive Bacterial Infections, Hospitals, Humans, Incidence, Sequence Analysis, DNA",

author = "Lester, {Camilla H} and Dorthe Sandvang and Stefan Olsen and Sch{\o}nheyder, {Henrik Carl} and Jarl{\o}v, {Jens Otto} and Bangsborg, {Jette Marie} and Hansen, {Dennis S} and Jensen, {Th{\o}ger Gorm} and Niels Frimodt-M{\o}ller and Hammerum, {Anette Marie} and {DANRES Study Group}",

year = "2008",

doi = "10.1093/jac/dkn360",

language = "English",

volume = "62",

pages = "1203--1206",

journal = "Journal of Antimicrobial Chemotherapy",

issn = "0305-7453",

publisher = "Oxford University Press",

number = "6",

}

TY - JOUR

T1 - Emergence of ampicillin-resistant Enterococcus faecium in Danish hospitals

AU - Lester, Camilla H

AU - Sandvang, Dorthe

AU - Olsen, Stefan

AU - Schønheyder, Henrik Carl

AU - Jarløv, Jens Otto

AU - Bangsborg, Jette Marie

AU - Hansen, Dennis S

AU - Jensen, Thøger Gorm

AU - Frimodt-Møller, Niels

AU - Hammerum, Anette Marie

AU - DANRES Study Group

PY - 2008

Y1 - 2008

N2 - BACKGROUND: Ampicillin-resistant Enterococcus faecium isolates are reported in increasing numbers in many European hospitals. The clonal complex 17 (CC17) characterized by ampicillin resistance has been associated with nosocomial E. faecium outbreaks and infections in five continents. The aim was to investigate how prevalent ampicillin resistance is in clinical E. faecium isolates from Denmark and to investigate their clonal affiliation, especially to CC17. METHODS: Microbiology data from 2002 through 2006 on E. faecium and Enterococcus faecalis blood isolates was received from Departments of Clinical Microbiology in 11 Danish counties. From January 2004 through December 2004, we collected 275 clinical enterococci from four of these departments. Multilocus sequence typing (MLST) and PFGE were performed on the 84 ampicillin-resistant E. faecium isolates from this collection. RESULTS: A 68% increase in the number of infections caused by enterococci was observed from 2002 through 2006. The increase was mainly caused by E. faecium isolates, which tripled, whereas the number of E. faecalis isolates increased by only 23% during the same period. There was also a significant increase in the number of ampicillin-resistant E. faecium isolates. MLST showed that 98% of the tested ampicillin-resistant E. faecium isolates belonged to CC17. PFGE showed eight different clusters and we found indications of clonal spread within the hospitals. CONCLUSIONS: Ampicillin-resistant E. faecium isolates have increased in frequency in Denmark during 2002-2006. Most of the ampicillin-resistant E. faecium isolates belong to complex CC17 Udgivelsesdato: 2008/12

AB - BACKGROUND: Ampicillin-resistant Enterococcus faecium isolates are reported in increasing numbers in many European hospitals. The clonal complex 17 (CC17) characterized by ampicillin resistance has been associated with nosocomial E. faecium outbreaks and infections in five continents. The aim was to investigate how prevalent ampicillin resistance is in clinical E. faecium isolates from Denmark and to investigate their clonal affiliation, especially to CC17. METHODS: Microbiology data from 2002 through 2006 on E. faecium and Enterococcus faecalis blood isolates was received from Departments of Clinical Microbiology in 11 Danish counties. From January 2004 through December 2004, we collected 275 clinical enterococci from four of these departments. Multilocus sequence typing (MLST) and PFGE were performed on the 84 ampicillin-resistant E. faecium isolates from this collection. RESULTS: A 68% increase in the number of infections caused by enterococci was observed from 2002 through 2006. The increase was mainly caused by E. faecium isolates, which tripled, whereas the number of E. faecalis isolates increased by only 23% during the same period. There was also a significant increase in the number of ampicillin-resistant E. faecium isolates. MLST showed that 98% of the tested ampicillin-resistant E. faecium isolates belonged to CC17. PFGE showed eight different clusters and we found indications of clonal spread within the hospitals. CONCLUSIONS: Ampicillin-resistant E. faecium isolates have increased in frequency in Denmark during 2002-2006. Most of the ampicillin-resistant E. faecium isolates belong to complex CC17 Udgivelsesdato: 2008/12

KW - Ampicillin

KW - Ampicillin Resistance

KW - Anti-Bacterial Agents

KW - Bacteremia

KW - Bacterial Typing Techniques

KW - Cluster Analysis

KW - Cross Infection

KW - DNA Fingerprinting

KW - Denmark

KW - Electrophoresis, Gel, Pulsed-Field

KW - Enterococcus faecalis

KW - Enterococcus faecium

KW - Genotype

KW - Gram-Positive Bacterial Infections

KW - Hospitals

KW - Humans

KW - Incidence

KW - Sequence Analysis, DNA

U2 - 10.1093/jac/dkn360

DO - 10.1093/jac/dkn360

M3 - Journal article

C2 - 18765412

SN - 0305-7453

VL - 62

SP - 1203

EP - 1206

JO - Journal of Antimicrobial Chemotherapy

JF - Journal of Antimicrobial Chemotherapy

IS - 6

ER -