Evidence for transmission between humans and the environment of a nosocomial strain of Enterococcus faecium.

• An ampicillin- and ciprofloxacin-resistant Enterococcus faecium (ARE) strain, named FMSE1, with a characteristic biochemical phenotype, was in a recent study found to dominate among faecal ARE isolates from patients in several Swedish hospitals. In the present study, the prevalence of this strain among 9676 enterococcal isolates from healthy children, hospital sewage, urban sewage, surface water, slaughtered animals (broilers, pigs and cattle) and pig faeces and manure was investigated. Enterococcal isolates having the same biochemical phenotype as the FMSE1 were most common in samples of hospital sewage (50%), surface water (35%), treated sewage (28%) and untreated sewage (17%), but rare in samples from healthy children (0.8%) and animals (2%). PFGE typing of FMSE1-like isolates from hospital sewage indicated that they were closely related to the nosocomial FMSE1 strain. Thus, this study indicated a possible transmission route for nosocomial E. faecium from patients in hospitals to hospital sewage and urban sewage, and further via treatment plants to surface water and possibly back to humans. This proposed route of circulation of drug-resistant enterococci might be further amplified by antibiotic usage in human medicine. In contrast, such transmission from food animals seems to play a negligible role in Sweden.

Nyckelord

Ampicillin Resistance

Animals

Anti-Infective Agents/pharmacology

Bacterial Typing Techniques

Carrier State/microbiology

Cattle

Chickens/microbiology

Ciprofloxacin/pharmacology

Cross Infection/*microbiology

DNA Fingerprinting

Drug Resistance; Bacterial/genetics

Electrophoresis; Gel; Pulsed-Field

Enterococcus faecium/*isolation & purification/*physiology

Feces/microbiology

Fresh Water/microbiology

Genotype

Gram-Positive Bacterial Infections/epidemiology/*microbiology

Human

Phenotype

Sewage/microbiology

Support; Non-U.S. Gov't

Swine/microbiology

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)