Clinical isolation of vancomycin-resistant Enterococcus faecalis in Taiwan

We report the isolation of a vancomycin-resistant strain of Enterococcus faecalis, designated AH803, from a 76-year-old Taiwanese woman with pneumonia and bacteremia. This is the first documented clinical isolation of a vancomycin-resistant enterococcus in Taiwan. AH803 was repeatedly isolated from sputum specimens of the patient. AH803 had a high level of vancomycin (minimal inhibitory concentration, MIC = 512 mu g/mL) and gentamicin (MIC > 2,000 mu g/mL) resistance, but was susceptible to teicoplanin (MIC = 8 mu g/mL) and ampicillin (MIC = 2 mu g/mL). AH803 was shown by polymerase chain reaction to have the vanA gene, but not the vanB gene. Despite treatment efforts, the patient's condition continued to deteriorate. She requested to be discharged, against medical advice. The patient died at home the following day after discharge.