a Departments of Microbiology, University Hospitals St Elisabeth and National Cancer Institutes, b Bratislava, c Nitra, d Tmava, e Kosice and f National Institute of Respiratory Diseases, Slovak Republic
Sir,
Vancomycin resistance among enterococcal bloodstream isolates in Europe is relatively low (0.13.5%).1,2 Among isolates from non-sterile body sites in Hungary, Poland, Czech Republic and Slovakia rates of 13%13 have been reported, whilst resistance in Austria is minimal (01%).4 The first signs of an increasing incidence of vancomycin-resistant enterococci (VRE) was reported from University Hospital Haematology and Oncology departments in Olomouc and Ostrava in 1999, where the proportion of VRE in Enterococcus faecium increased to 10%, whilst E. faecium represented 12.5% of all isolates.5,6 However, VRE screening was not performed in these studies16 (Table).
|
Strains from blood cultures were isolated by a semiautomated system (Bactec or Bact-Alert) and identified with the Vitek Jr system (bioMérieux, Hazelwood, MI, USA). E. faecium were identified with API 20 STREP (bioMérieux, Marcy lEtoile, France). DNA fingerprinting was not performed. Among 132 enterococcal bacteraemias detected, VRE accounted for 6.8% and teicoplanin resistance was found in 5.3% of all enterococcal bloodstream isolates (88.6% Enterococcus faecalis, 9.1% E. faecium, 4.3% Enterococcus gallinarum). However, vancomycin resistance in E. faecium was 33.3% and teicoplanin resistance 16.7% (Table). Resistance to chloramphenicol, tetracycline, ampicillin and gentamicin was higher among strains of E. faecium than in E. faecalis (Table
).
Our survey has shown 6.8% vancomycin resistance and 5.3% teicoplanin resistance among bloodstream isolates. Therefore nationwide surveys in other Central/Eastern European countries including Russia, Ukraine and the Baltic republics, on the epidemiology of glycopeptide resistance are needed.
Notes
J Antimicrob Chemother 2001;47:362-364
* Correspondence address. St Elisabeth and Trnava University, Heydukova 10, 812 50 Bratislava, Slovak Republic. E-mail: krcmery{at}spamba.sk
References
1 . Schouten, M. A. and the European Enterococcus spp. Study Group (1999). Vancomycin resistant enterococci. Prevalence in Europe. Abstracts of the 9th ECCMID, Berlin. Clinical Microbiology and Infection 8, Suppl. 1, 136.
2 . Krcméry, V., Jr, Hryniewicz, W., Ludwig, E., Radzilowski, H., Stratchoynsky, C. & Navachin, S. M. (1998). Epidemiology of antimicrobial resistance in Central/Eastern Europe. Journal of Public Health 1, 1330.
3 . Hryniewicz, W. (1999). Antibiotic Resistance in Central Europe. Abstracts 9th ECCMID, Berlin, 1999. Clinical Microbiology and Infection 8, Suppl. 1, Abstract 234.
4 . Allerberger, F., Lass, C. F., Dierich, M., Hirsch, A., Presterl, E., Haas, G. et al. (1997). Vancomycin resistant enterococci in Austria. Wien Klinische Wochenschrift 109, 31220.
5 . Kollar, M. (1999). Susceptibility of enterococci to vancomycin. Report from a university hospital hematology ward. Clinical Microbiology. 5, 137.
6 . Urbásková, P. (1999). Survey of resistance of enterococcal isolates to antibiotics in Czech Republic. Clinical Microbiology 6, 1138.