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Previous Volume 345:1155-1160 October 18, 2001 Number 16 Next

	Full Text PDF Editorial by Gorbach, S. L. Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background The combination of the streptogramins quinupristin and dalfopristin was approved in the United States in late 1999 for the treatment of vancomycin-resistant Enterococcus faecium infections. Since 1974, another streptogramin, virginiamycin, has been used at subtherapeutic concentrations to promote the growth of farm animals, including chickens.

Methods To determine the frequency of quinupristin-dalfopristin–resistant E. faecium, we used selective medium to culture samples from chickens purchased in supermarkets in Georgia, Maryland, Minnesota, and Oregon and stool samples from outpatients.

Results Between July 1998 and June 1999, samples from 407 chickens from 26 stores in four states were cultured, as were 334 stool samples from outpatients. Quinupristin-dalfopristin–resistant E. faecium was isolated from 237 chicken carcasses and 3 stool specimens. The resistant isolates from stool had low-level resistance (minimal inhibitory concentration [MIC], 4 µg per milliliter; resistance was defined as a MIC of at least 4 µg per milliliter). The resistant isolates from chickens in general had higher levels of resistance (MICs ranging from 4 to 32 µg per milliliter; MIC required to inhibit 50 percent of isolates, 8 µg per milliliter).

Conclusions Quinupristin-dalfopristin – resistant E. faecium contaminates a large proportion of chickens sold in U.S. supermarkets. However, the low prevalence and low level of resistance of these strains in human stool specimens suggest that the use of virginiamycin in animals has not yet had a substantial influence. Foodborne dissemination of resistance may increase, however, as the clinical use of quinupristin-dalfopristin increases.

Source Information

From the Hospital Infections Program (L.C.M., B.H.) and the Foodborne and Diarrheal Diseases Branch (S.R., F.J.A.), Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta; the University of Maryland, Baltimore (C.M., Y.Y.W.); the Minnesota Department of Health, Minneapolis (S.J., M.S.); the Oregon Health Division, Portland (R.S., E.D.); and Georgia Division of Public Health, Atlanta (L.G., J.A.B.).

Address reprint requests to Dr. Angulo at the Centers for Disease Control and Prevention, 1600 Clifton Rd., MS A38, Atlanta, GA 30333, or at fangulo{at}cdc.gov.

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