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

Nancy Carolina Corredor, Carolina López, Paula Andrea Aguilera, Lina María Prieto, Giovanni Rodríguez-Leguizamón, Aura Lucía Leal, María Victoria Ovalle-Guerro, Juan Mauricio Pardo-Oviedo, Claudia Elena Chica, Manuel Alfonso Patarroyo

Resultado de la investigación: Contribución a RevistaArtículo

Resumen

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.

Idioma originalEnglish (US)
Páginas (desde-hasta)258
PublicaciónBMC Infectious Diseases
Volumen19
N.º1
DOI
EstadoPublished - mar 15 2019

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Corredor, Nancy Carolina ; López, Carolina ; Aguilera, Paula Andrea ; Prieto, Lina María ; Rodríguez-Leguizamón, Giovanni ; Leal, Aura Lucía ; Ovalle-Guerro, María Victoria ; Pardo-Oviedo, Juan Mauricio ; Chica, Claudia Elena ; Patarroyo, Manuel Alfonso. / An epidemiological and molecular study regarding the spread of vancomycin-resistant Enterococcus faecium in a teaching hospital in Bogotá, Colombia 2016. En: BMC Infectious Diseases. 2019 ; Vol. 19, N.º 1. pp. 258.
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title = "An epidemiological and molecular study regarding the spread of vancomycin-resistant Enterococcus faecium in a teaching hospital in Bogot{\'a}, Colombia 2016",
abstract = "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 M{\'e}deri 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.",
author = "Corredor, {Nancy Carolina} and Carolina L{\'o}pez and Aguilera, {Paula Andrea} and Prieto, {Lina Mar{\'i}a} and Giovanni Rodr{\'i}guez-Leguizam{\'o}n and Leal, {Aura Luc{\'i}a} and Ovalle-Guerro, {Mar{\'i}a Victoria} and Pardo-Oviedo, {Juan Mauricio} and Chica, {Claudia Elena} and Patarroyo, {Manuel Alfonso}",
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An epidemiological and molecular study regarding the spread of vancomycin-resistant Enterococcus faecium in a teaching hospital in Bogotá, Colombia 2016. / Corredor, Nancy Carolina; López, Carolina; Aguilera, Paula Andrea; Prieto, Lina María; Rodríguez-Leguizamón, Giovanni; Leal, Aura Lucía; Ovalle-Guerro, María Victoria; Pardo-Oviedo, Juan Mauricio; Chica, Claudia Elena; Patarroyo, Manuel Alfonso.

En: BMC Infectious Diseases, Vol. 19, N.º 1, 15.03.2019, p. 258.

Resultado de la investigación: Contribución a RevistaArtículo

TY - JOUR

T1 - An epidemiological and molecular study regarding the spread of vancomycin-resistant Enterococcus faecium in a teaching hospital in Bogotá, Colombia 2016

AU - Corredor, Nancy Carolina

AU - López, Carolina

AU - Aguilera, Paula Andrea

AU - Prieto, Lina María

AU - Rodríguez-Leguizamón, Giovanni

AU - Leal, Aura Lucía

AU - Ovalle-Guerro, María Victoria

AU - Pardo-Oviedo, Juan Mauricio

AU - Chica, Claudia Elena

AU - Patarroyo, Manuel Alfonso

PY - 2019/3/15

Y1 - 2019/3/15

N2 - 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.

AB - 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.

UR - https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-3877-7

U2 - 10.1186/s12879-019-3877-7

DO - 10.1186/s12879-019-3877-7

M3 - Article

C2 - 30876395

VL - 19

SP - 258

JO - BMC Infectious Diseases

JF - BMC Infectious Diseases

SN - 1471-2334

IS - 1

ER -