Hostname: page-component-848d4c4894-2xdlg Total loading time: 0 Render date: 2024-07-05T15:57:59.307Z Has data issue: false hasContentIssue false

Recovery of High-Level Streptomycin-Resistant Enterococci From Hemodialysis Water and Dialysate in 85 Greek Renal Units

Published online by Cambridge University Press:  02 January 2015

Malamatenia Arvanitidou
Affiliation:
Department of Hygiene, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
Argiri Vayona
Affiliation:
Department of Hygiene, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
Alkis Pigadas
Affiliation:
Department of Hygiene, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
Athanassios Tsakris*
Affiliation:
Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
*
Department of Microbiology, Medical School, Aristotle University of Thessaloniki, 54006 Thessaloniki, Greece

Abstract

In the 85 renal units of Greece, enterococci were recovered from 10 samples of tap water, 6 of treated hemodialysis water, and 21 of dialysate. Eleven isolates were Enterococcus faecium, and 8 were Enterococcus raffinosus; 6 other additional enterococcal species were found. Twenty-two strains exhibited high-level resistance to streptomycin, 16 were resistant to rifampicin, and one to erythromycin. In our hemodialysis units, treated water and dialysate raise concern regarding transfer to patients of uncommon enterococcal species exhibiting high-level streptomycin resistance.

Type
Concise Communications
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Kessler, M, Hoen, B, Mayeux, D, Hestin, D, Fontenaille, C. Bacteremia in patients on chronic hemodialysis. A multicenter prospective survey. Nephron 1993;64:95100.Google Scholar
2. Tokars, JI, Miller, ER, Alter, MJ, Arduino, MJ. National surveillance of dialysis associated diseases in the United States, 1995. ASAIO J 1998;44:98107.CrossRefGoogle ScholarPubMed
3. Du Moulin, GC, Coleman, EC Jr, Hedley-Whyte, J. Bacterial colonization and endotoxin content of a new renal dialysis water system composed of acrylonitrile butadiene styrene. Appi Environ Microbiol 1987;53:13221326.CrossRefGoogle ScholarPubMed
4. Favero, MS. Dialysis-associated diseases and their control. In: Bennett, JV, Brachman, PS, eds. Hospital Infections. 2nd ed. Boston, MA Little Brown & Co; 1985:267284.Google Scholar
5. Phillips, G, Hudson, S, Stewart, WK. Persistence of microflora in biofilm within fluid pathways of contemporary hemodialysis monitors (Gambro AK-10). J Hosp Infect 1994;27:117125.Google Scholar
6. Association for the Advancement of Medical Instrumentation. AAMI Standards and Recommended Practices, vol 3. Arlington, VA: American National Standards Institute; 1993:1332.Google Scholar
7. Klein, E, Pass, T, Harding, GB, Wright, R, Million, C. Microbial and endotoxin contamination in water and dialysate in the central United States. Artif Organs 1990;14:8594.Google Scholar
8. Laurence, RA, Lapierre, ST. Quality of hemodialysis water. A 7-year multicenter study. Am J Kidney Dis 1995;25:738750.Google Scholar
9. Bambauer, R, Schauer, M, Jung, WK, Daum, V, Vienken, J. Contamination of dialysis water and dialysate. A survey of 30 centers. ASAIO J 1994;40:10121016.Google Scholar
10. American Public Health Association. Fecal Streptococcus and Enterococcus groups. In: Eaton, AD, Clesceri, LS, Greenberg, AE, eds. Standard Methods for the Examination of Water and Wastewater. 19th ed. Washington, DC: APHA; 1995:7074.Google Scholar
11. Facklam, RR, Collins, MD. Identification of Enterococcus species isolated from human infection by a conventional test scheme. J Clin Microbiol 1989;27:731734.Google Scholar
12. National Committee for Clinical Laboratory Standards. Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically. 3rd ed. Approved standard. Document M7-A3. Villanova, PA- NCCLS; 1993.Google Scholar
13. Longfield, RN, Wortham, WG, Fletcher, LL, Nauscheutz, WF. Clustered bacteremias in a hemodialysis unit: cross-contamination of blood tubing from ultrafiltrate waste. Infect Control Hosp Epidemiol 1992;13:160164.Google Scholar
14. Brown, AR, Amyes, SGB, Paton, R, Plant, WD, Stevenson, GM, Winney, RJ, et al. Epidemiology and control of vancomycin-resistant enterococci (VRE) in a renal unit. J Hosp Infect 1998;40:115124.Google Scholar
15. Tsakris, A, Pournaras, S, Douboyas, J. Changes in antimicrobial resistance of enterococci isolated in Greece. J Antimicrob Chemother 1997;40:735737.Google Scholar