Description of a nosocomial outbreak of infection caused by a vanA-containing strain of Enterococcus faecalis in La Coruna, Spain

892 In 1988, Megraud et al.3 reported the first isolation of UPTC from human clinical infection, where these organisms were isolated from an appendix as well as from human faeces. This group of organisms is the Campylobacter found most frequently in shellfish and waters. UPTC organisms were isolated by selective enrichment from shellfish grown in several marine inshore waters around Northern Ireland, as previously described.4 From these samples, 21 isolates of this taxon were obtained and their susceptibility to ciprofloxacin (5 μg), enrofloxacin (5 μg), ofloxacin (5 μg), tetracycline (30 μg) and erythromycin (5 μg) was determined by disc susceptibility testing, in accordance with NCCLS methodology. As there is no standardized disc method specifically for Campylobacter, including guidance criteria for interpretation of zone sizes, susceptibility was assigned arbitrarily in comparison with known resistant and susceptible clinical isolates of Campylobacter jejuni, Campylobacter coli and Campylobacter lari isolated from human faeces. Results demonstrated that none of the environmental campylobacters isolated from the shellfish was resistant to any of the antibiotic agents tested. Although UPTC have been described occasionally in humans, we have not identified any of these organisms as a cause of gastrointestinal disease from human faecal specimens submitted to the Northern Ireland Public Health Laboratory for the period 1980–present, nor have we been able to isolate these from the stools of healthy individuals. Similarly, we have not been able to isolate these organisms from poultry in Northern Ireland. Previously, we have reported that the niche for these organisms has been aquatic environments and wild seagulls.1,5 Consequently, as these organisms have never been isolated from human and animal sources, where antibiotics may have been used, it is unlikely that they have developed or acquired resistance mechanisms to overcome artificial antibiotic selective pressure. Conversely, where fluoroquinolones have been used in Northern Ireland and the Republic of Ireland in human and animal populations, we do experience varying degrees of fluoroquinolone resistance.6,7 This report therefore suggests that where selective antibiotic pressure is not applied, fluoroquinolone resistance is less likely to be acquired. Therefore, this report supports the concept of minimizing the employment of such antibiotics in both human and veterinary medicine to help reduce the burden of antibiotic resistance.