A new gene test can identify a dangerous bacterium endemic in US hospitals

March 15, 2001

Good bug, bad bug

and now threatening Europe

A fast, simple test can now reveal whether a hospital patient is carrying a

highly virulent, antibiotic-resistant bug or a near identical relation which

is much less harmful.

Patients carrying the dangerous version could be kept away from particularly

vulnerable groups, such as organ transplant recipients, says Rob Willems of

the National Institute of Public Health in Bilthoven. They could also be

isolated to help stop the bug spreading.

Vancomycin-resistant Enterococcus faecium is carried in the intestine. In

the US, it is endemic in hospitals, but is not widely carried by healthy

people. In Europe, however, many healthy people carry VREF but epidemics in

hospitals in rare.

Willems' team investigated this contrast and found that there are two

closely-related but distinct types of VREF. The type that causes hospital

epidemics has variations in a gene associated with increased virulence in a

related bacterium.

Rapid spread

" We can take a sample from a patient, do a genetic test, and have a result

in two to three hours, " Willems told New Scientist. " Here is a very easy way

of telling who is carrying the hospital-related VREF and who isn't. "

VREF can be fatal to people with suppressed immune systems, and cannot be

killed by any existing antibiotics. " As a result, patients remain infectious

for prolonged periods of time. This is an important explanation for the

rapid spread of these bacteria in the US, " Willems says.

Increased use of vancomycin in Europe to treat " superbugs " such as MRSA

(methicillin-resistant Staphylococcus aureus) is now resulting in VREF

outbreaks in European hospitals, Willems says. He hopes the new gene test

will help slow the spread of these outbreaks.

More at: The Lancet (vol 357, p 853)

Correspondence about this story should be directed to

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1020 GMT, 13 March 2001

Emma Young

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