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dc.typeArtigo de periódicopt_BR
dc.titleClonal Dissemination Of Vana-type Glycopeptide-resistant Enterococcus Faecalis Between Hospitals Of Two Cities Located 100 Km Apart.pt_BR
dc.contributor.authorMoretti, M Lpt_BR
dc.contributor.authorBratfich, O Jpt_BR
dc.contributor.authorStucchi, R Bpt_BR
dc.contributor.authorLevi, Cpt_BR
dc.contributor.authorLevin, A Spt_BR
dc.contributor.authorDuboc, G Mpt_BR
dc.contributor.authorVormittag, Ept_BR
dc.contributor.authorBlum-Menezes, Dpt_BR
unicamp.authorM L Moretti, Laboratório de Epidemiologia Molecular e Moléstias Infecciosas, Divisão de Moléstias Infecciosas, Faculdade de Ciências Médicas, Universidade Estadual de CampinasCampinas, SP, Brasil. moretti@hc.unicamp.brpt_BR J Bratfich,pt B Stucchi,pt Levi,pt S Levin,pt M Duboc,pt Vormittag,pt Blum-Menezes,pt
dc.subjectAnti-bacterial Agentspt_BR
dc.subjectBacterial Proteinspt_BR
dc.subjectCarbon-oxygen Ligasespt_BR
dc.subjectCross Infectionpt_BR
dc.subjectDisease Outbreakspt_BR
dc.subjectEnterococcus Faecalispt_BR
dc.subjectGram-positive Bacterial Infectionspt_BR
dc.subjectMicrobial Sensitivity Testspt_BR
dc.subjectPolymerase Chain Reactionpt_BR
dc.subjectVancomycin Resistancept_BR
dc.description.abstractNosocomial dissemination of glycopeptide-resistant enterococci represents a major problem in hospitals worldwide. In Brazil, the dissemination among hospitals in the city of São Paulo of polyclonal DNA profiles was previously described for vancomycin-resistant Enterococcus faecium. We describe here the dissemination of VanA phenotype E. faecalis between two hospitals located in different cities in the State of São Paulo. The index outbreak occurred in a tertiary care university hospital (HCUSP) in the city of São Paulo and three years later a cluster caused by the same strain was recognized in two patients hospitalized in a private tertiary care hospital (CMC) located 100 km away in the interior of the state. From May to July 1999, 10 strains of vancomycin-resistant E. faecalis were isolated from 10 patients hospitalized in the HCUSP. The DNA genotyping using pulsed-field gel electrophoresis (PFGE) showed that all isolates were originated from the same clone, suggesting nosocomial dissemination. From May to July 2002, three strains of vancomycin-resistant E. faecalis were isolated from two patients hospitalized in CMC and both patients were colonized by the vancomycin-resistant Enterococcus in skin lesions. All isolates from CMC and HCUSP were highly resistant to vancomycin and teicoplanin. The three strains from CMC had minimum inhibitory concentration >256 micro g/ml for vancomycin, and 64 (CMC 1 and CMC 2) and 96 micro g/ml (CMC 3) for teicoplanin, characterizing a profile of VanA resistance to glycopeptides. All strains had the presence of the transposon Tn1546 detected by PCR and were closely related when typed by PFGE. The dissemination of the E. faecalis VanA phenotype among hospitals located in different cities is of great concern because E. faecalis commonly colonizes the gastrointestinal tract of patients and healthy persons for periods varying from weeks to years, which, together with the persistence of vancomycin-resistant Enterococcus in hospital rooms after standard cleaning procedures, increases the risk of the dissemination and reservoir of the bacteria.en
dc.relation.ispartofBrazilian Journal Of Medical And Biological Research = Revista Brasileira De Pesquisas Médicas E Biológicas / Sociedade Brasileira De Biofísica ... [et Al.]pt_BR
dc.relation.ispartofabbreviationBraz. J. Med. Biol. Res.pt_BR
dc.identifier.citationBrazilian Journal Of Medical And Biological Research = Revista Brasileira De Pesquisas Médicas E Biológicas / Sociedade Brasileira De Biofísica ... [et Al.]. v. 37, n. 9, p. 1339-43, 2004-Sep.pt_BR
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