Clinical isolation of vancomycin-resistant Enterococcus faecalis in Taiwan. 1996

R J Ben, and J J Lu, and T G Young, and W M Chi, and C C Wang, and M L Chu, and J C Wang
Department of Medicine, 802 Army General Hospital, Kaohsiung, Taiwan, ROC.

We report the isolation of a vancomycin-resistant strain of Enterococcus faecalis, designated AH803, from a 76-year-old Taiwanese woman with pneumonia and bacteremia. This is the first documented clinical isolation of a vancomycin-resistant enterococcus in Taiwan. AH803 was repeatedly isolated from sputum specimens of the patient. AH803 had a high level of vancomycin (minimal inhibitory concentration, MIC = 512 micrograms/mL) and gentamicin (MIC > 2,000 micrograms/mL) resistance, but was susceptible to teicoplanin (MIC = 8 micrograms/mL) and ampicillin (MIC = 2 micrograms/mL). AH803 was shown by polymerase chain reaction to have the vanA gene, but not the vanB gene. Despite treatment efforts, the patient's condition continued to deteriorate. She requested to be discharged, against medical advice. The patient died at home the following day after discharge.

UI MeSH Term Description Entries
D004352 Drug Resistance, Microbial The ability of microorganisms, especially bacteria, to resist or to become tolerant to chemotherapeutic agents, antimicrobial agents, or antibiotics. This resistance may be acquired through gene mutation or foreign DNA in transmissible plasmids (R FACTORS). Antibiotic Resistance,Antibiotic Resistance, Microbial,Antimicrobial Resistance, Drug,Antimicrobial Drug Resistance,Antimicrobial Drug Resistances,Antimicrobial Resistances, Drug,Drug Antimicrobial Resistance,Drug Antimicrobial Resistances,Drug Resistances, Microbial,Resistance, Antibiotic,Resistance, Drug Antimicrobial,Resistances, Drug Antimicrobial
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D012703 Serotyping Process of determining and distinguishing species of bacteria or viruses based on antigens they share. Serotypings
D013183 Sputum Material coughed up from the lungs and expectorated via the mouth. It contains MUCUS, cellular debris, and microorganisms. It may also contain blood or pus. Sputum, Induced,Induced Sputum,Induced Sputums,Sputums,Sputums, Induced
D013293 Enterococcus faecalis A species of gram-positive, coccoid bacteria commonly isolated from clinical specimens and the human intestinal tract. Most strains are nonhemolytic. Streptococcus Group D,Streptococcus faecalis
D014640 Vancomycin Antibacterial obtained from Streptomyces orientalis. It is a glycopeptide related to RISTOCETIN that inhibits bacterial cell wall assembly and is toxic to kidneys and the inner ear. AB-Vancomycin,Diatracin,VANCO-cell,Vanco Azupharma,Vanco-saar,Vancocin,Vancocin HCl,Vancocine,Vancomicina Abbott,Vancomicina Chiesi,Vancomicina Combino Phar,Vancomicina Norman,Vancomycin Hexal,Vancomycin Hydrochloride,Vancomycin Lilly,Vancomycin Phosphate (1:2),Vancomycin Phosphate (1:2), Decahydrate,Vancomycin Sulfate,Vancomycin-ratiopharm,Vancomycine Dakota,Hydrochloride, Vancomycin,Sulfate, Vancomycin
D016133 Polymerase Chain Reaction In vitro method for producing large amounts of specific DNA or RNA fragments of defined length and sequence from small amounts of short oligonucleotide flanking sequences (primers). The essential steps include thermal denaturation of the double-stranded target molecules, annealing of the primers to their complementary sequences, and extension of the annealed primers by enzymatic synthesis with DNA polymerase. The reaction is efficient, specific, and extremely sensitive. Uses for the reaction include disease diagnosis, detection of difficult-to-isolate pathogens, mutation analysis, genetic testing, DNA sequencing, and analyzing evolutionary relationships. Anchored PCR,Inverse PCR,Nested PCR,PCR,Anchored Polymerase Chain Reaction,Inverse Polymerase Chain Reaction,Nested Polymerase Chain Reaction,PCR, Anchored,PCR, Inverse,PCR, Nested,Polymerase Chain Reactions,Reaction, Polymerase Chain,Reactions, Polymerase Chain
D016470 Bacteremia The presence of viable bacteria circulating in the blood. Fever, chills, tachycardia, and tachypnea are common acute manifestations of bacteremia. The majority of cases are seen in already hospitalized patients, most of whom have underlying diseases or procedures which render their bloodstreams susceptible to invasion. Bacteremias

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