This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (27)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Valerie A. Chirurgi, MD; Sharon E. Oster, MD; Andreina A. Goldberg, MT; Robert E. McCabe, MD

Arch Intern Med. 1992;152(7):1457-1461.

Abstract
Background.—
A recent prospective study at the Department of Veterans Affairs Medical Center, Martinez, Calif, revealed that 9% of enterococcal clinical isolates were ampicillin resistant. We prospectively studied 100 patients hospitalized in one general medicine ward and in the medical intensive care unit to study determinants of acquisition of ampicillin-resistant enterococcus.

Methods. —
Rectal swabs and urine cultures were obtained from patients within 72 hours of admission to the study ward and twice weekly until discharge from the ward or the intensive care unit. Cultures were obtained from the hands of personnel and from environmental surfaces in the general medical ward and the intensive care unit. Ampicillin-resistant enterococcal isolates were examined for molecular relatedness by plasmid DNA analysis.

Results.—
The cultures from 23 patients yielded ampicillin-resistant enterococci. The rectal swabs yielded ampicillin-resistant enterococci before the urine cultures did except in one patient whose urine and rectal cultures were both positive on the same day. Acquisition of ampicillin-resistant enterococci was significantly associated with previous antimicrobial agents, Foley catheterization, and being bedridden. Resistant enterococci were not isolated from hospital personnel or environmental surfaces. Plasmid analysis by gel electrophoresis demonstrated nine strains, two of which predominated. Rectal and urine isolates from the same patient had identical plasmid electrophoresis patterns.

Conclusions.—
We conclude that ampicillin-resistant enterococci are common in the rectal flora, can spread to the urinary system, are associated with patient characteristics that predispose to nosocomial infection, and may become an emerging clinical problem.

(Arch Intern Med. 1992;152:1457-1461)

Author Affiliations
From the Medical Service, Department of Veterans Affairs Medical Center, Martinez, Calif (Drs Chirurgi, Oster, and McCabe and Ms Goldberg), and the Department of Medicine, University of California Medical School, Davis (Drs Chirurgi and McCabe).

Footnotes
Accepted for publication January 17, 1992.

Reprint requests to 309 Willow Creek Ln, Martinez, CA 94553 (Dr Chirurgi).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

High acquisition and environmental contamination rates of CC17 ampicillin-resistant Enterococcus faecium in a Dutch hospital
de Regt et al.
J Antimicrob Chemother 2008;62:1401-1406.
ABSTRACT | FULL TEXT  

Risk factors associated with ampicillin resistance in patients with bacteraemia caused by Enterococcus faecium
Fortun et al.
J Antimicrob Chemother 2002;50:1003-1009.
ABSTRACT | FULL TEXT  

Geographic Distribution of a Large Mobile Element That Transfers Ampicillin and Vancomycin Resistance between Enterococcus faecium Strains
Hanrahan et al.
Antimicrob. Agents Chemother. 2000;44:1349-1351.
ABSTRACT | FULL TEXT  

Cephalosporins as Risk Factor for Nosocomial Enterococcus faecalis Bacteremia: A Matched Case-Control Study
Pallares et al.
Arch Intern Med 1993;153:1581-1586.
ABSTRACT