Diversity of Tn1546 and Its Role in the Dissemination of Vancomycin-Resistant Enterococci in Portugal

ABSTRACT We characterized the molecular diversity of vanA vancomycin-resistant enterococci (VRE; 176 isolates/87 pulsed-field gel electrophoresis types) from different sources and cities in Portugal (1996 to 2004): (i) food animals (FA; n = 38 isolates out of 31 samples), hospitalized humans (HH; n = 101/101), healthy human volunteers (HV; n = 7/4), and environmental sources (n = 30/10). Some strains were isolated from different hosts and persistently recovered for years. Twenty-four Tn1546 variants were identified, all located on plasmids (30 to 250 kb). Some Tn1546 variants were associated with specific sources such as FA (3 types), HH (11 types), or HV (1 type), while others were recovered from isolates of different origins (8 types). Polymorphisms in the central vanRSHA region of Tn1546 were scarcely detected, while alterations upstream of vanR and downstream of vanA were frequently identified involving mutations (vanS and vanX), deletions (vanY), insertions (IS1216V, ISEf1, and IS19; sequences with or without homology with others available in GenBank databases), and different genetic rearrangements. Most Tn1546 variants contained IS1216V (14 types) or ISEf1 (6 types). IS1216V was found alone or associated with an IS3-like element at different orientations and positions in Tn1546 from human, animal, and environmental samples. ISEf1 was located within vanX-vanY region at nucleotide 9044 of Tn1546 variants mostly associated with clinical isolates, suggesting a common genetic platform. IS19 was observed within the vanX-vanY region in one Tn1546 variant from poultry. Recent spread of VRE in Portugal reflects a complex epidemiology involving both clonal spread and plasmid dissemination containing a variety of Tn1546 types. Apparent Tn1546 heterogeneity among enterococci from human, animal, and environmental sources might reflect frequent genetic exchange events and evolution of particular widely disseminated genetic elements.

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Characterization of the Mechanisms of Fluoroquinolone Resistance in Vancomycin-Resistant Enterococci of Different Origins

Journal of Chemotherapy ◽

10.1179/joc.2011.23.2.87 ◽

2011 ◽

Vol 23 (2) ◽

pp. 87-91 ◽

Cited By ~ 13

Author(s):

M. López ◽

C. Tenorio ◽

R. Del Campo ◽

M. Zarazaga ◽

C. Torres

Keyword(s):

Fluoroquinolone Resistance ◽

Vancomycin Resistant Enterococci ◽

Vancomycin Resistant ◽

Different Origins

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In Vivo Transfer of the vanA Resistance Gene from an Enterococcus faecium Isolate of Animal Origin to an E. faecium Isolate of Human Origin in the Intestines of Human Volunteers

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.50.2.596-599.2006 ◽

2006 ◽

Vol 50 (2) ◽

pp. 596-599 ◽

Cited By ~ 146

Author(s):

Camilla H. Lester ◽

Niels Frimodt-Møller ◽

Thomas Lund Sørensen ◽

Dominique L. Monnet ◽

Anette M. Hammerum

Keyword(s):

Resistance Genes ◽

Enterococcus Faecium ◽

Animal Origin ◽

Intestinal Colonization ◽

Human Origin ◽

Vancomycin Resistant Enterococci ◽

Human Volunteers ◽

Vancomycin Resistant ◽

Faecium Isolate

ABSTRACT Transient colonization by vancomycin-resistant enterococci of animal origin has been documented in the intestines of humans. However, little is known about whether transfer of the vanA gene occurs in the human intestine. Six volunteers ingested a vancomycin-resistant Enterococcus faecium isolate of chicken origin, together with a vancomycin-susceptible E. faecium recipient of human origin. Transconjugants were recovered in three of six volunteers. In one volunteer, not only was vancomycin resistance transferred, but also quinupristin-dalfopristin resistance. This study shows that transfer of the vanA gene from an E. faecium isolate of animal origin to an E. faecium isolate of human origin can occur in the intestines of humans. It suggests that transient intestinal colonization by enterococci carrying mobile elements with resistance genes represents a risk for spread of resistance genes to other enterococci that are part of the human indigenous flora, which can be responsible for infections in certain groups of patients, e.g., immunocompromised patients.

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Phenotypic and Genotypic Identification of Vancomycin Resistant Enterococci from Different Sources

Zagazig Veterinary Journal ◽

10.21608/zvjz.2017.7688 ◽

2017 ◽

Vol 45 (1) ◽

pp. 64-73

Author(s):

Adel Attia ◽

Ahlam Gharib ◽

Ibrahim Mohamed ◽

Omnia Ahmed

Keyword(s):

Vancomycin Resistant Enterococci ◽

Vancomycin Resistant ◽

Genotypic Identification ◽

Different Sources

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High diversity of vancomycin-resistant Enterococcus faecium isolated in Southern Brazil

10.7287/peerj.preprints.27817 ◽

2019 ◽

Author(s):

Renata O Soares ◽

Gabriela R Cunha ◽

Vinicius P Perez ◽

Jussara L Siqueira ◽

Gustavo E Sambrano ◽

...

Keyword(s):

Profile Analysis ◽

Southern Brazil ◽

Porto Alegre ◽

Vancomycin Resistant Enterococci ◽

Antimicrobial Susceptibility Profile ◽

Vancomycin Resistant ◽

Clonal Spread ◽

High Level ◽

Relationship Of ◽

Level Resistance

Background. Vancomycin-resistant enterococci (VRE) are common in some hospital settings and their clonal spread has been described in different regions of the world. We determined the antimicrobial susceptibility profile and the clonal relationship of VRE isolates recovered from inpatients at three general hospitals of Porto Alegre, Brazil. Results. Ninety-four VRE were characterized as Enterococcus faecium and exhibited resistance to teicoplanin, ampicillin, ciprofloxacin, and susceptibility to linezolid, quinupristin-dalfopristin and daptomycin. High level resistance to gentamicin was detected in 13.8% of them. All VREfm harbored vanA gene, while 85.1% and 94.7% harbored respectively esp and acm virulence genes. PFGE profile analysis revealed 23 clonal types including 79 isolates, while 15 isolates exhibited unique pattern type, showing a polyclonal distribution of VREfm in Southern Brazil. Conclusion. These findings contribute to the local understanding regarding the characteristics of the circulating VREs in the region.

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Khwam R. Al-Husseiny Isolation of the vancomycin resistant enterococci from different sources

10.32792/utq/utjsci/vol21//8 ◽

2019 ◽

pp. 56-71

Keyword(s):

Vancomycin Resistant Enterococci ◽

Vancomycin Resistant ◽

Different Sources

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Regional spread ofvanA- orvanB-positiveEnterococcus gallinarumin hospitals and long-term care facilities in Kyoto prefecture, Japan

Epidemiology and Infection ◽

10.1017/s0950268810001123 ◽

2010 ◽

Vol 139 (3) ◽

pp. 430-436 ◽

Cited By ~ 3

Author(s):

M. SHIRANO ◽

S. TAKAKURA ◽

M. YAMAMOTO ◽

Y. MATSUMURA ◽

A. MATSUSHIMA ◽

...

Keyword(s):

Term Care ◽

Resistance Determinants ◽

Vancomycin Resistant Enterococci ◽

Care Facilities ◽

Single Clone ◽

Vancomycin Resistant ◽

Clonal Spread ◽

Enterococcus Gallinarum ◽

Regional Surveillance

SUMMARYFollowing an outbreak ofvanA-positiveEnterococcus faeciumin 2005 in Kyoto prefecture, regional surveillance of vancomycin-resistant enterococci (VRE) was initiated. This revealedvanA- orvanB-positiveEnterococcus gallinarumin multiple facilities. Eighty-eightvanA-positiveE. gallinarumfaecal carriers from 12 facilities and tenvanB-positiveE. gallinarumfaecal carriers from eight facilities were found. Pulsed-field gel electrophoresis profiles of the first isolate from each facility showed that 11 of the 12vanAisolates and three of the eightvanB-positiveE. gallinarumisolates belonged to a single clone. This study confirms the clonal spread ofvanA- orvanB-positiveE. gallinarumin a region and underlines the importance of surveillance of VRE for the presence of vancomycin resistance determinants.

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High diversity of vancomycin-resistant Enterococcus faecium isolated in Southern Brazil

10.7287/peerj.preprints.27817v1 ◽

2019 ◽

Author(s):

Renata O Soares ◽

Gabriela R Cunha ◽

Vinicius P Perez ◽

Jussara L Siqueira ◽

Gustavo E Sambrano ◽

...

Keyword(s):

Profile Analysis ◽

Southern Brazil ◽

Porto Alegre ◽

Vancomycin Resistant Enterococci ◽

Antimicrobial Susceptibility Profile ◽

Vancomycin Resistant ◽

Clonal Spread ◽

High Level ◽

Relationship Of ◽

Level Resistance

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Quantitative Efficacy of Alcohol-Based Handrub against Vancomycin-Resistant Enterococci on the Hands of Human Volunteers

Infection Control and Hospital Epidemiology ◽

10.1086/663342 ◽

2012 ◽

Vol 33 (1) ◽

pp. 98-100 ◽

Cited By ~ 8

Author(s):

M. L. Grayson ◽

S. A. Ballard ◽

W. Gao ◽

S. Khumra ◽

P. Ward ◽

...

Keyword(s):

Vancomycin Resistant Enterococci ◽

Human Volunteers ◽

Vancomycin Resistant

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Molecular Analysis of Vancomycin-Resistant Enterococci Isolated from Regional Hospitals in Trinidad and Tobago

Advances in Medicine ◽

10.1155/2016/8762691 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 6

Author(s):

Patrick E. Akpaka ◽

Shivnarine Kissoon ◽

Padman Jayaratne

Keyword(s):

Trinidad And Tobago ◽

Genetic Relatedness ◽

Molecular Techniques ◽

Control Measures ◽

Infection Control Measures ◽

Vancomycin Resistant Enterococci ◽

Random Amplification ◽

Vancomycin Resistant ◽

Clonal Spread ◽

Regional Hospitals

Geographic spread of vancomycin-resistant enterococci (VRE) clones in cities, countries, or even continents has been identified by molecular techniques. This study aimed at characterizing virulent genes and determining genetic relatedness of 45 VRE isolates from Trinidad and Tobago using molecular tools, including polymerase chain reaction, pulsed-field gel electrophoresis (PFGE), and Random Amplification Polymorphic DNA (RAPD). The majority (84%) of the isolates wereEnterococcus faeciumpossessingvanA gene while the rest (16%) wereEnterococcus faecalispossessingvanB. Theespgene was found in all 45 VRE isolates whilehylgenes were found only inE. faeciumspecies. TheE. faeciumspecies expressed five distinct PFGE patterns. The predominant clones with similar or common patterns belonged to clones one and three, and each had 11 (29%) of the VRE isolates. Plasmid content was identified in representative isolates from each clonal group. By contrast, theE. faecalisspecies had one PFGE pattern suggesting the presence of an occult and limited clonal spread. The emergence of VRE in the country seems to be related to intra/interhospital dissemination of an epidemic clone carrying thevanA element. Therefore, infection control measures will be warranted to prevent any potential outbreak and spread of VRE in the country.

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