Acquisition of antibiotic-resistant Enterococcus faecium strains during long-term hospitalization and fast adaptation of enterococcal flora to antibiotic treatment: A case report

• Published in: International journal of hygiene and environmental health Vol. 212; no. 1; pp. 105 - 108
• Main Authors: Schulte, Berit, Wolz, Christiane, Schumacher, Ulrike, Beyser, Kurt, Heeg, Peter, Borgmann, Stefan
• Format: Journal Article
• Language: English
• Published: München Elsevier GmbH 2009; Elsevier
• Subjects: Adaptation, Biological; Air. Soil. Water. Waste. Feeding; Anti-Bacterial Agents - therapeutic use; Bacterial Infections - drug therapy; Biological and medical sciences; Biological Evolution; Drug Resistance, Bacterial - genetics; E. faecium; Enterococcus faecium - genetics; Enterococcus faecium - pathogenicity; Environment. Living conditions; Female; Hospitalization; Humans; Linezolid; Medical sciences; Microbial Sensitivity Tests; Middle Aged; Miscellaneous; Public health. Hygiene; Public health. Hygiene-occupational medicine; Quinupristine/dalfopristine; Toxicology; Vancomycin; Vancomycin Resistance - genetics; Linezolid; Vancomycin; Quinupristine/dalfopristine; E. faecium; Peptides; Health and environment; Glycopeptide; Bacteria; Micrococcales; Protein synthesis inhibitor; Oxazole derivatives; Public health; Adaptation; Treatment resistance; Hospitalization; Acquisition; Long term; Case study; Streptococcaceae; Enterococcus faecium; Antibiotic; Treatment; Polypeptide; Oxazolidinone derivative; Environmental medicine; Antibacterial agent
• ISSN: 1438-4639; 1618-131X
• DOI: 10.1016/j.ijheh.2007.12.003

Recently, it has been suspected that long durations of hospitalization might be a possible risk factor to get colonized by multiple VRE strains. Here we present the case of a patient who underwent stem cell transplantation and subsequently stayed at the hospital for about 4 months until death. At least four different
Enterococcus faecium strains were identified from routinely taken microbiological specimens as demonstrated by pulsed-field gel-electrophoresis. Additionally, these strains showed variable susceptibility to quinupristine/dalfopristine, vancomycin, and/or linezolid depending on different antibiotic administrations.
These findings indicate that patients might be colonized with multiple
Enterococcus faecium strains and that the enterococcal flora quickly adapts due to antibiotic exposure.