The use of a genetic amplification technique (LCx MTB) to diagnose extrapulmonary tuberculosis

Abstract

Concise Communications 6 5performed in a primary and secondary healthcare center and it possibly indicates the colonization rate of the community. This first VRE clinical isolate of the VanB phenotype is probably the tip of the vancomycin resistance 'iceberg' in our hospital. It indlcates a possible need for adjustments in the testing of vancomycin resistance and in VRE carriage surveillance in all tertiary-care institutions, since the transfer of seriously ill patients h m one hospital to another is common practice. Clinical laboratories must adopt a sensitivity testing method that is able to recognize the VanB phenotype, and should also apply a surveillance program for VRE based on the agar-screening test. They must also try to reinforce the infection control policies, to reduce the risk of nosocomial transmission of VRE. References 1. 2.3. 4. 5.6. MurrayBE. The life and times of the enterococcus. Clin Microbiol Rev 1990; 3: 46-65. Chenoweth C, Shaberg D. The epidemiology of enterococci. Eur J Clin Microbiol Infect Dis 1990; 9 80-9. Murray BE. What can we do about vancomycin-resistant enterococci? Clin Infect Dis 1995; 20: 1134-6. Jordens JZ, Bates J, Gri6ths DT. Faecal carriage and nosocomial spread of vancomycin-mistant Enterococasfaccium. J Antimicrob Chemother 1994; 3 4 515-28. Van der Auwera P, Pensart N, Korten V, M u p y B, Ledercq R. Influence of oral glycopeptide on the fecal flora of human volunteers: selection of highly glycopeptide-resistant enterococci. J Infect Dis 1996; 173: 1129-36. Dutka-Mallen S, Even S, C o d n P. Detection of glycopeptide mistance genotypes and idendcation to the species level of clinically relevant enterococci by P C R J Clin Microbiol 1995; 33(1): 24-7. 7. Murray BE. Diversity among multidrug-resistant enterococci. 8. 9 10. 11. 12. 13.14. 15. 16. Emerg Infect Dis1998; 4(1): 3 7 4 7 . Leqlerc R, Derlot E, D u d J, Courvalin P. Plasmid-mediated resistance to vancomycin and teicoplanin in EnterommcsfarEium. N Engl J Med 1988; 319 15761. Swenson JM, Clark NM, Ferraro MJ, et al. Development of a standardized screening method for detection of vancomycinresistant enterococci. J Clin Microbiol 1997; 3 2 0 : 17004. Giamarcllou H, Xirouchaki E, the Amfiaraeion Center for Chemotherapeutic Studies. Epidemiology of nosocomid Entero-COCNS spp. isolates from hospitals in Athens [abstract 1551. In: Program and absacts of the 23rd Panhellenic Medical Conference, Athens, Greece. Athens: Athens Medical Society, 1997 41. WHONET Greece. Susceptibility results of Gnm-positive cocci for the period Jan-Dec 1997. Arch Hellenic Med 1998; 15(2): 221-2. Douboyas J, Tsakris A. Prevalence of antibiotic resistance among enterococci isolated in Greece. J Antimicrob Chemother 1995; 35: 236-8. Tsakris A, Pournaras S, Douboyas J. Changes in antimicrobial resistance of enterococci isolated in Greece. J Antimicrob Chemother 1997; 4 0 735-7. Papaparaskevas J, Stefanou J, Tdvn M, Zoga P, Matsas M, Avlami A. Using the WHONET softwve to monitor antibiotic resistance in a large teaching hospital; results for the y...