The clinical and molecular epidemiology of glycopeptide-resistant
Enterococcus faecium was
investigated during an outbreak on a renal unit. Forty-nine patients were
colonized or infected
during a 15-month period. Sites of colonization included faeces, urine,
intravenous (IV)
catheter tips and wound swabs. Ten patients had infections, which included
five bacteraemias
and three episodes of peritonitis. Pulsed-field gel electrophoresis of
43 patient isolates of
glycopeptide-resistant E. faecium identified seven strains during
the first 7 months of the
outbreak. Three of these strains affected five or more patients. One
strain accounted for 17/43
isolates. Isolates that were possibly related to another renal unit
strain were cultured from
patients at two other Manchester hospitals. These isolates were
epidemiologically-related, and
may represent a single Manchester epidemic strain. Of five patients who
had multiple isolates
of glycopeptide-resistant E. faecium, three had isolates
representing a single strain and two
were colonized or infected by more than one strain.