First vancomycin-resistant blood isolate of Enterococcus faecium in a children’s hospital and molecular analysis of the mechanism of resistance
Belgin Altun1, A. Bülent Cengiz2, Ateş Kara2, Mehmet Ceyhan2, Serhat Ünal1, Gülten Seçmeer2, Deniz Gür3
1Departments of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
2 Departments of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
3Departments of Clinical Microbiology Laboratory, İhsan Doğramacı Children’s Hospital, Ankara, Turkey
Altun B, Cengiz AB, Kara A, Ceyhan M, Ünal S, Seçmeer G,
Gür D. First vancomycin-resistant blood isolate of Enterococcus faecium in a
children’s hospital and molecular analysis of the mechanism of resistance.
Turk J Pediatr 2008; 50: 554-558.
The first clinical isolate of vancomycin-resistant Enterococcus spp. in Hacettepe
University Children’s Hospital was isolated from a blood culture of a patient
hospitalized in the intensive care unit. He had been on vancomycin therapy
for the last four months for consecutive pneumoniae and sepsis. The isolate
was identified as Enterococcus faecium (E. faecium) and minimal inhibitor
concentration (MIC) values were determined as >256 µg/ml and 256 µg/ml
for vancomycin and teicoplanin, respectively, with E-test. The isolate was
shown to carry the vanA gene with polymerase chain reaction (PCR). Twelve
colonizing strains were isolated from the surveillance cultures during the same
period and identified as E. faecium, and were also shown to carry the vanA
gene. However, arbitrarily-primed-PCR and pulsed-field gel electrophoresis
results could not confirm the source of the resistant strain nor did they
suggest a clonal spread in the hospital.