SCAN: Epidemiology of nosocomial multidrug-resistant enterococci

Tittle: Epidemiology of nosocomial multidrug-resistant enterococci. Infection and colonization

Abstract: Enterococci are normal inhabitants of the gastrointestinal tract of human and animals. Out of 23 species, Enterococcus faecalis and Enterococcus faecium are responsible for the majority of clinically relevant infections. The importance of enterococci as a leading cause of nosocomial infections is related with the occurrence of high-level resistance to multiple antimicrobial drug agents, and in particular to vancomycin, which is the last option for treatment of Gram positive infections. Since the isolation of the first vancomycin resistant enterococci (VRE), identified in 1987 in Europe, the rates of VRE associated with bloodstream infections in inpatients increased up to 25% in the United States and to 7.8% in Europe. Portugal was one of five European countries that reported a frequency of E. faecium resistant to vancomycin of more than 25% in 2006. A well hospital-adapted clonal complex of vancomycin-resistant E. faecium (known as CC17) has been identified in Europe and its continuous spread is alarming and poses serious problems for hospital infection control practitioners. Since nosocomial infections have major impact in public health, the main goal of this laboratory is focused on tracking epidemiological aspects of enterococcal infections occurring in Portugal. Results from these studies are expected to have repercussions on guidelines for infection control and antimicrobial prescription policies and for the design of continuous surveillance strategies.