4137.0: Tuesday, November 14, 2000 - Board 0

Abstract #7570

Bridging the Laboratory and Public Health: A Two-Year Review of Molecular Typing of Vancomycin-resistant Enterococci in a Metropolitan Hospital

Marc-Oliver Wright, MT(ASCP)1, V. Stosor, MD2, L. Peterson, MD2, and S. Paule2. (1) School of Public Health, University of Illinois-Chicago and Northwestern Memorial Hospital, 250 East Superior St, Room 565, Chicago, IL 60610, 312-908-1233, mwright@nmh.org, (2) Northwestern Memorial Hospital

Abstract Text: Extended surveillance of VRE in a metropolitan hospital is a seemingly difficult task. Our facility initiated a molecular epidemiology laboratory to routinely perform molecular strain typing by restriction endonuclease analysis (REA) of genomic VRE DNA. The analysis is then reviewed by an infection control committee of physicians, nurses, pharmacists and technologists on a periodic basis and potential nosocomial transmission patterns are evaluated. This poster summarizes the presence and clonality of VRE in our facility over a two-year period and it's effect on transmission. Results: Between January 1998 and December 1999, 493 isolates were collected from 440 patients. Of these, 467 (94.7%) were categorized into 74 distinct clonal genotypes. Twenty-nine genotypes were of significant magnitude to implicate the possibility of nosocomial transmission, while the remaining isolates reflected a sporadic dispersion. Of the 74 genotypes, 10 (13.5%) accounted for 338 (72.3%) of all isolates. The remaining genotypes occurred in smaller clusters ranging between 2 and 13 patients. Two particular genotypes accounted for 35.6% of all isolates during this two-year time span. Conclusions: The polyclonal nature of VRE requires active surveillance of this pathogen in order to monitor the level of nosocomial acquisition in our facility. Active surveillance that includes molecular typing permits us to effectively initiate infection control measures to limit transmission of numerous clones between patients.

Learning Objectives: Objectives: assess the nature of nosocomial infection of vancomycin-resistant enterococci (VRE) in our facility; utilize molecular based laboratory techniques to identify and limit potential transmission

Keywords: Antibiotic Resistance, Hospitals

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: employed at: Northwestern Memorial Hospital

The 128th Annual Meeting of APHA