ABSTRACT
No disponible
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Respiratory Syncytial Virus, Human/pathogenicity , Respiratory Syncytial Virus Infections/epidemiology , Disease Outbreaks , Communicable Disease Control/methodsSubject(s)
Cross Infection/epidemiology , Disease Outbreaks , Hematologic Neoplasms/complications , Infection Control/methods , Respiratory Syncytial Virus Infections/epidemiology , Adult , Antiviral Agents/adverse effects , Antiviral Agents/therapeutic use , Bronchial Spasm/chemically induced , Cross Infection/drug therapy , Cross Infection/prevention & control , Cross Infection/transmission , Disease Susceptibility , Female , Hand Hygiene , Hematology , Hospital Departments , Hospitals, University , Humans , Male , Middle Aged , Respiratory Syncytial Virus Infections/drug therapy , Respiratory Syncytial Virus Infections/prevention & control , Respiratory Syncytial Virus Infections/transmission , Ribavirin/adverse effects , Ribavirin/therapeutic useABSTRACT
No disponible
Subject(s)
Humans , Clostridioides difficile/isolation & purification , Clostridium Infections/epidemiology , Hematopoietic Stem Cell Transplantation , Cross Infection/epidemiology , Disease Outbreaks , Hospital UnitsSubject(s)
Clostridioides difficile/isolation & purification , Clostridium Infections/epidemiology , Cross Infection/epidemiology , Disease Outbreaks , Hematopoietic Stem Cell Transplantation , Hospital Units , Clostridium Infections/prevention & control , Clostridium Infections/transmission , Cross Infection/microbiology , Disease Outbreaks/prevention & control , Hand Disinfection , Humans , Risk Management , Spain/epidemiologySubject(s)
Hepatitis B Vaccines , Hepatitis B/genetics , Liver Transplantation , Mutation , Postoperative Complications/genetics , Female , Humans , Middle AgedABSTRACT
OBJECTIVES: To report a clonal outbreak of ST17 vancomycin-resistant Enterococcus faecium (VREfm) carrying Tn1546 (vanA) in a haemo-oncology ward of a tertiary teaching hospital in the south of Spain (January-September 2009). PATIENTS AND METHODS: Twenty-two VREfm strains from 13 patients were characterized by PFGE, multiple-locus variable-number tandem-repeat analysis (MLVA) and multilocus sequence typing (MLST). Genes encoding antibiotic resistance and putative virulence traits and the Tn1546 backbone were investigated by PCR. Plasmid characterization included determination of size (S1-PFGE) and replication modules (PCR, hybridization and sequencing). Patient clinical records were analysed retrospectively. RESULTS: A single ST17 E. faecium clone (MT-7 MLVA type) carrying esp and hyl plus a 30 kb Inc18-like::Tn1546 (IS1216) plasmid was identified. Ampicillin resistance was linked to PBP5 showing mutations at positions 24, 27, 34, 66, 68, 85, 100, 144, 172, 177, 204, 216, 324, 462, 466', 470, 485, 496, 499, 525, 546, 558, 582, 586, 629, 632, 642 and 667. Other resistance genes identified were erm(B), ant(6')-Ia and aph(3')-IIIa. Fluoroquinolone resistance was attributable to ParC (Arg-61 â Gly and Ser-80 â Arg) and GyrA (Ser-83 â Arg) mutations. CONCLUSIONS: A nosocomial outbreak caused by an ST17 (CC17) E. faecium clone harbouring Esp and Hyl and a 30 kb Inc18-like::Tn1546 plasmid among haemo-oncology patients is reported. The failure of early infection control practices indicates an undetected reservoir and the ability of this strain to persist over long periods. The potential spread of epidemic clones and broad host plasmids carrying vancomycin resistance in Spain is of concern since it might contribute towards a higher rate of VREfm infection.
