First isolation of vancomycin-resistant enteroccoci and spread of a single clone in a university hospital in northwestern Turkey

Reported here is the first isolation of vancomycin-resistant Enterococcus (VRE) at a hospital in northwestern Turkey and a description of the ensuing outbreak investigation. The first isolate was obtained from a wound culture of a patient in an intensive care unit. Thereafter, a total of 205 rectal swabs, 67 skin swabs and 123 environmental samples were screened, revealing five more VRE isolates. All isolates showed similar antibiotic resistance patterns, except for two that differed regarding gentamicin resistance. The vanA gene was present in all isolates. Pulsed-field gel electrophoresis demonstrated that all isolates belonged to a single clone, with the gentarnicin-resistant isolates demonstrating two-band differences. This is the first outbreak to be caused by spread of a single VRE clone in Turkey; it was successfully controlled by strict adherence to appropriate infection control practices.