Multidrug‐resistantEnterococcus faeciumin a Patient with Burns

Abstract

Enterococcus species represent an important nosocomial pathogen. In the United States between 1992 and 1999, intensive care unit-associated enterococcal infections accounted for 13.5% of primary bloodstream infections, 1.7% of pneumonia infections, and 13.8% of urinary tract infections [1]. In recent years, concern has been expressed regarding the increase in antimicrobial resistance among enterococci [2, 3]. Enterococci are intrinsically resistant to many antibiotics, including the cephalosporins, semisynthetic penicillins, and aminoglycosides. Acquired resistance to penicillins, macrolides, fluoroquinolones, and vancomycin has been frequently described. Two newer agents, linezolid and quinupristin/dalfopristin, have been demonstrated to have activity against Enterococcus species resistant to other drug classes [4–5]. We describe a patient with extensive burns who developed infection with a strain of Enterococcus faecium resistant to multiple drugs, including vancomycin, ampicillin, and gentamicin, as well as linezolid and quinupristin/dalfopristin.