The first recorded outbreak of VRE in Hungary involving vanB carrying E. faecium isolates from clinical samples and from the hospital environment

Abstract number: 1134_01_361

Libisch B., Gacs M., Tirczka T., Pászti J., Glatz K., Bognár M., Major M., Konkoly-Thege M., Füzi M.


The aim of this study was to investigate and confirm by phenotypic and molecular methods the first reported outbreak of vancomycin resistant enterococci (VRE) in Hungary and to uncover the epidemiological relationship between the outbreak isolates.


The isolates were screened on a 6 mg/l vancomycin-BHI plate as recommended by NCCLS. Vancomycin and teicoplanin MIC values were determined for the screen-positive isolates by the E-test. Identification was achieved by basic biochemical tests, motility in SIM medium, the Crystal GP system and by PCR amplification of the ddl and vanC genes. vanA and vanB genes were detected by PCR. Clonal relationship between the VRE isolates was determined by PFGE.


The outbreak strains were isolated at a hematology unit in Budapest during 2003 and 2004. The initial investigation confirmed vanB positive E. faecium isolates from six blood cultures, one urine sample, eight faecal samples and three environmental samples. All these isolates were found to be epidemiologically related to each-other by macrorestriction (PFGE) analysis but unrelated to vanB negative E. faecium isolates obtained from the same hospital. One vanA carrying E. faecium was also isolated from the faecal sample of a hospital administrator which was clearly unrelated to the outbreak strains. VRE carriage was not detected for any other member of the hospital staff, however, a comparatively high percentage of the carriage of vanC positive isolates (E. casseliflavus and E. gallinarum) was observed.


This is the first report of vanB carrying VRE from Hungary and also the first report of an outbreak caused by VRE. These results suggest that a screening and monitoring system has to be implemented to prevent the further dissemination of VRE in the country.

Session Details

Date: 01/08/2007
Time: 00:00-00:00
Session name: XXIst ISTH Congress
Location: Oxford, UK
Presentation type:
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