An epidemiological and molecular study regarding the spread of vancomycin-resistant Enterococcus faecium in a teaching hospital in Bogotá, Colombia 2016

Background: Enterococcus faecium is ranked worldwide as one of the top ten pathogens identified in healthcare-associated infections (HAI) and is classified as one of the high priority pathogens for research and development of new antibiotics worldwide. Due to molecular biology techniques' higher costs, the approach for identifying and controlling infectious diseases in developing countries has been based on clinical and epidemiological perspectives. Nevertheless, after an abrupt vancomycin-resistant Enterococcus faecium dissemination in the Méderi teaching hospital, ending up in an outbreak, further measures needed to be taken into consideration. The present study describes the vancomycin-resistant Enterococcus faecium pattern within Colombian's largest installed-bed capacity hospital in 2016. Methods: Thirty-three vancomycin-resistant Enterococcus faecium isolates were recovered during a 5-month period in 2016. Multilocus variable-number tandem-repeat analysis was used for molecular typing to determine clonality amongst strains. A modified time-place-sequence algorithm was used to trace VREfm spread patterns during the outbreak period and estimate transmission routes. Results: Four clonal profiles were identified. Chronological clonal profile follow-up suggested a transitional spread from profile 'A' to profile 'B', returning to a higher prevalence of 'A' by the end of the study. Antibiotic susceptibility indicated high-level vancomycin-resistance in most isolates frequently matching vanA gene identification. Discussion: Transmission analysis suggested cross-contamination via healthcare workers. Despite epidemiological control of the outbreak, post-outbreak isolates were still being identified as having outbreak-related clonal profile (A), indicating reduction but not eradication of this clonality. This study supports the use of combined molecular and epidemiological strategies in an approach to controlling infectious diseases. It contributes towards a more accurate evaluation of the effectiveness of the epidemiological measures taken regarding outbreak control and estimates the main cause related to the spread of this microorganism. © 2019 The Author(s).

• Fecha de publicación: 2019
• Institución: Universidad del Rosario
• Repositorio: Repositorio EdocUR - U. Rosario
• Idioma: eng
• OAI Identifier: oai:repository.urosario.edu.co:10336/23565
• Acceso en línea: https://doi.org/10.1186/s12879-019-3877-7; https://repository.urosario.edu.co/handle/10336/23565
• Palabra clave: Antibiotic sensitivity; Article; Bacterial gene; Bacterial strain; Bacterial transmission; Bacterium contamination; Bacterium isolate; Clinical article; Clonal variation; Colombia; Controlled study; Cross-sectional study; Descriptive research; Disease surveillance; Enterococcus faecium; Epidemic; Gene identification; Genetic algorithm; Hospital infection; Human; Molecular dynamics; Molecular typing; Nonhuman; Observational study; Phenotype; Prevalence; Retrospective study; Sequence analysis; Teaching hospital; Vana gene; Vancomycin resistant enterococcus; Variable number of tandem repeat; Bacterium identification; Classification; Drug effect; Enterococcus faecium; Epidemic; Genetics; Gram positive infection; Isolation and purification; Microbial sensitivity test; Microbiology; Molecular epidemiology; Multilocus sequence typing; Teaching hospital; Transmission; Vancomycin resistant enterococcus; Antiinfective agent; Bacterial protein; Vancomycin; Anti-bacterial agents; Bacterial proteins; Bacterial typing techniques; Colombia; Disease outbreaks; Enterococcus faecium; Gram-positive bacterial infections; Humans; Microbial sensitivity tests; Molecular epidemiology; Multilocus sequence typing; Vancomycin; Vancomycin-resistant enterococci; Antimicrobial resistance; Outbreak surveillance; Time-place-sequence algorithm; Vancomycin-resistant enterococcus faecium; teaching; Hospitals
• License: Abierto (Texto Completo)