Original Research

First outbreak of vancomycin-resistant Enterococcus in a haematology unit in Durban, South Africa

Yesholata Mahabeer, Warren Lowman, Chetna N. Govind, Khine Swe-Swe-Han, Koleka P. Mlisana
Southern African Journal of Infectious Diseases | Vol 31, No 1 | a100 | | © 2019 Yesholata Mahabeer, Warren Lowman, Chetna N. Govind, Khine Swe-Swe-Han, Koleka P. Mlisana | This work is licensed under CC Attribution 4.0
Submitted: 16 May 2019 | Published: 31 March 2016

About the author(s)

Yesholata Mahabeer, Department of Medical Microbiology, National Health Laboratory Service, Durban, South Africa; School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
Warren Lowman, Vermaak and Partners Pathologists, Pretoria, South Africa; Department of Microbiology, Department of Clinical Microbiology and Infectious Disease, School of Pathology, University of Witwatersrand, Johannesburg, South Africa
Chetna N. Govind, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa; Lancet Laboratories, Durban, South Africa; School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
Khine Swe-Swe-Han, Department of Medical Microbiology, National Health Laboratory Service, Durban, South Africa; School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
Koleka P. Mlisana, Department of Medical Microbiology, National Health Laboratory Service, Durban, South Africa; School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa

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Abstract

Vancomycin resistant enterococci (VRE) are increasingly important causes of morbidity and mortality in developed countries. Although VRE is a significant cause of nosocomial sepsis in these countries, limited data is available on the role that this pathogen plays in South Africa. We describe the demographic, clinical and genotypic data of seven patients involved in the first outbreak of VRE in a haematology unit at a tertiary hospital in Durban and also report the isolation of VRE from six patients from other wards in this hospital and from hospitals outside Durban. The outbreak occurred from 19 April 2011 to 9 November 2011. Pulse Field Gel Electrophoresis (PFGE) was conducted on 15 clinical and environmental samples. Two closely-related clusters and a unique strain were identified from both clinical and environmental samples. Furthermore, the predominant cluster was found in other hospitals in KwaZulu-Natal. After infection control practices were reinforced, the outbreak terminated. Our study highlights that VRE is an emerging pathogen in KZN, especially in high risk units. The environment serves as a significant reservoir of VRE and infection control strategies should be directed to reduce the transmission of VRE from environmental sources.

Keywords

enterococci; infection control; outbreak; resistance; vancomycin

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