[Study of the first outbreak of vanA enterococcus faecium in the Canary Islands]. / Estudio del primer brote por Enterococcus faecium vanA en Canarias.

INTRODUCTION: In July, 2005 the first vancomycin-resistant Enterococcus faecium (VREF) with a genotype vanA was isolated in Hospital Universitario de Canarias (HUC). From September to December 2005, VREF vanA was isolated from another 15 patients (3 nosocomial infections and 12 rectal carriers). All of them were kidney transplant patients hospitalized in the Nephrology ward. This study describes the first VREF vanA outbreak in the HUC and the epidemiological link of the first VREF vanA isolates found in another two university hospitals in the Canary Islands. MATERIALS AND METHODS: We studied a total of 22 VREF isolates by microbiological and molecular methods. Epidemiological and clinical data of the patients involved were collected. RESULTS AND CONCLUSIONS: We confirmed that these VREF isolates belonged to the same clone using pulse-field gel electrophoresis (PFGE). In November 2005 and February 2006, the first VREF were isolated in two other University Hospitals in the Canary Islands and we also confirmed the link with the HUC cluster by comparison of patient-related information with the molecular typing data. These VREF isolates belonged to the ST18 associated to the Clonal Complex-17 (CC17). CC17 is the major hospital adapted lineage, representing a polyclonal population and associated to VREF outbreaks and infections in the five continents.

Estudio del primer brote por Enterococcus faecium vanA en Canarias / Study ofthefirstoutbreakof vanA enterococcus faecium in thecanaryislands

Introducción En julio de 2005 se aisló el primer Enterococcus faecium resistente a vancomicina (EFRV) genotipo vanA en el Hospital Universitario de Canarias en un paciente trasplantado renal ingresado en la Unidad de Nefrología. En los meses siguientes se aisló EFVR en otros 15 pacientes trasplantados renales ingresados en la misma unidad. Nuestro objetivo fue estudiar este primer brote de EFVR vanA en el Hospital Universitario de Canarias y el vínculo epidemiológico con los aislamientos de EFVR vanA encontrados también en otros 2 hospitales universitarios ubicados en las Islas Canarias. Material y métodos Se estudiaron mediante métodos microbiológicos y moleculares un total de 22 aislamientos de EFRV y las historias clínicas de los 22 pacientes de los que se aislaron. Resultados y conclusiones e confirmó mediante electroforesis de campo pulsante que los aislamientos del brote pertenecían a una misma clona y, a su vez, se confirmó el vínculo epidemiológico con los primeros aislamientos en los otros 2 hospitales universitarios relacionando los resultados moleculares con los datos epidemiológicos. Todos los aislamientos pertenecían a la secuencia tipo ST18 mediante multilocus sequence typing, asociado al complejo clonal 17. El complejo clonal 17 es un linaje que comprende una población policlonal que se ha adaptado bien al ambiente hospitalario y que se aísla en los 5 continentes (AU)

Introduction In July, 2005 the first vancomycin-resistant Enterococcus faecium (VREF) with a genotype vanA was isolated in Hospital Universitario de Canarias (HUC). From September to December 2005, VREF vanA was isolated from another 15 patients (3 nosocomial infections and 12 rectal carriers). All of them were kidney transplant patients hospitalized in the Nephrology ward. This study describes the first VREF vanA outbreak in the HUC and the epidemiological link of the first VREF vanA isolates found in another two university hospitals in the Canary Islands. Materials and methods We studied a total of 22 VREF isolates by microbiological and molecular methods. Epidemiological and clinical data of the patients involved were collected. Results and conclusions We confirmed that these VREF isolates belonged to the same clone using pulse-field gel electrophoresis (PFGE). In November 2005 and February 2006, the first VREF were isolated in two other University Hospitals in the Canary Islands and we also confirmed the link with the HUC cluster by comparison of patient-related information with the molecular typing data. These VREF isolates belonged to the ST18 associated to the Clonal Complex-17 (CC17). CC17 is the major hospital adapted lineage, representing a polyclonal population and associated to VREF outbreaks and infections in the five continents (AU)

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