Acquisition of antibiotic-resistant Enterococcus faecium strains during long-term hospitalization and fast adaptation of enterococcal flora to antibiotic treatment: A case report

Recently, it has been suspected that long durations of hospitalization might be a possible risk factor to get colonized by multiple VRE strains. Here we present the case of a patient who underwent stem cell transplantation and subsequently stayed at the hospital for about 4 months until death. At least four different Enterococcus faecium strains were identified from routinely taken microbiological specimens as demonstrated by pulsed-field gel-electrophoresis. Additionally, these strains showed variable susceptibility to quinupristine/dalfopristine, vancomycin, and/or linezolid depending on different antibiotic administrations.These findings indicate that patients might be colonized with multiple Enterococcus faecium strains and that the enterococcal flora quickly adapts due to antibiotic exposure.