FORTUN J, MORENO L, MARTIN-DAVILA P, COQUE TM, LOZA E, MORENO S; Interscience Conference on Antimicrobial Agents and Chemotherapy.

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2000 Sep 17-20; 40: 431.

Ramon y Cajal Hosp., Madrid, Spain

BACKGROUND: Epidemiological characteristics related to ampicillin-resistance and vancomycin-susceptibility in E.faecium strains are not well known. Recently, these enterococci strains have been proposed as the substratum for the later appearance of vancomycin-resistance E. faecium. Materials andMETHODS: We reviewed medical charts of patients with bacteremia due to E.faecium diagnosed in our Inst. during the last six years (1994-1999). Demographic and clinical characteristics, and antibiotic exposure previous to E. faecium bacteremia were analyzed. A CASE was defined as a patient with bacteremia caused by E. faecium with ampicilllin resistance (CMI >16 microg/ml, NCCLS criteria). Patients with E. faecium bacteremia due to ampicillin-susceptible strains were considered as CONTROLS. Clonality between different strains were analyzed performing a pulse field gel electrophoresis (PFGE) method.RESULTS: We diagnosed 49 cases of E. faecium bacteremia. Twenty-nine cases and 20 controls were identified. In the multivariate analysis the following variables were independent risk factors associated with E. faecium resistance to ampicillin: urinary catheterization ( OR: 0.2; IC95%: 0.03-1.0), previous betalactams exposure ( OR: 0.17; IC95%: 0.03-0.92) and quinolones exposure (p<0.01). PFGE analyses revealed an strong association between specific ampicillin-resistant clones and the location of patients during hospitalization (p=0.009).CONCLUSIONS: Ampicillin-resistance in patients with bacteremia due to E. faecium is independently associated with previous exposure to betalactams and quinolones and with urinary catheterization. Grouping of same clones in specific hospital wards suggests a nosocomial transmission.KEYWORDS: Ampicillin resistance; Bacteremia; Enterococcus faecium

Publication Types:

• Meeting Abstracts

Keywords:

• Ampicillin
• Ampicillin Resistance
• Anti-Bacterial Agents
• Bacteremia
• Case-Control Studies
• Electrophoresis, Gel, Pulsed-Field
• Enterococcus faecium
• Humans
• Risk Factors
• Vancomycin
• Vancomycin Resistance

Other ID:

• GWAIDS0010026

UI: 102247524

From Meeting Abstracts