ABSTRACT
E. faecium was the first reported VRE species, carrying the vanA gene in Brazil. In spite of this, vancomycin-resistant E. faecalis has become the predominant species in Brazilian hospitals. The aim of this study was to evaluate the genetic relatedness of VREs isolated in a Brazilian teaching hospital eight years apart from its first isolation. We analyzed 38 VRE strains obtained from 81 surveillance cultures of patients admitted to the four largest intensive care units in Hospital São Paulo in February, 2006. Presence of the vanA gene was assayed by PCR and PFGE analysis was used for molecular characterization. All VRE strains carried the vanA gene. Two distinct clonal groups were observed among vancomycin-resistant E. faecalis. Vancomycin-resistant E. faecium belonged to five distinct clones were demonstrated by molecular typing. All of these clones were different from the first vancomycin-resistant enterococci clone isolated eight years ago in our hospital.
E. faecium contendo o gene vanA foi a primeira espécie de VRE descrita, no Brasil. Apesar disto, E. faecalis resistente a vancomicina tem se tornado a espécie predominante nos hospitais brasileiros.O objetivo desse estudo foi avaliar a relação genética de VREs isolados em um hospital de ensino brasileiro após oito anos de seu primeiro isolamento. Analisamos 37 isolados de VRE obtidos de 81 culturas de vigilância de pacientes admitidos nas quatro maiores Unidades de Tratamento Intensivo em Fevereiro de 2006. A presença do gene vanA foi analisada por PCR e a caracterização molecular por PFGE. Todas as amostras VRE carreavam o gene vanA. Entre os E. faecalis vancomicina-resistentes, dois distintos grupos clonais foram observados. E. faecium resistente a vancomicina pertencentes a cinco clones distintos foram demonstrados por tipagem molecular. Todos esses clones foram diferentes do primeiro clone de enterococo resistente a vancomicina isolado oito anos atrás em nosso hospital.
Subject(s)
Humans , Bacterial Proteins/genetics , Carbon-Oxygen Ligases/genetics , Enterococcus faecalis/genetics , Enterococcus faecium/genetics , Vancomycin Resistance/genetics , Brazil , DNA, Bacterial/analysis , Electrophoresis, Gel, Pulsed-Field , Enterococcus faecalis/drug effects , Enterococcus faecium/drug effects , Feces/microbiology , Genotype , Phenotype , Polymerase Chain ReactionABSTRACT
Handwashing compliance was compared at two medical- surgical intensive care units (ICUs) of a teaching and a non-teaching hospital. The mean compliance was 22.2 percent and 42.6 percent, respectively. Respiratory therapists at the non-teaching hospital had the best handwashing compliance (52.6 percent). Nursing assistants at the teaching hospital had the worst compliance (11.5 percent). Nursing assistant was the only health-care worker category with a significant difference between the two ICUs (odds ratio = 6.0; 95 percent confidence interval = 3.83-9.43; p< 0.001).