scholarly journals Population Structure of Enterococcus faecium Causing Bacteremia in a Spanish University Hospital: Setting the Scene for a Future Increase in Vancomycin Resistance?

2005 ◽  
Vol 49 (7) ◽  
pp. 2693-2700 ◽  
Author(s):  
Teresa M. Coque ◽  
Rob J. L. Willems ◽  
Jesús Fortún ◽  
Janetta Top ◽  
Sergio Diz ◽  
...  
Keyword(s):  
Enterococcus Faecium ◽  
Fragment Length Polymorphism ◽  
Hospital Setting ◽  
Clonal Diversity ◽  
Vancomycin Resistance ◽  
University Hospital ◽  
Vancomycin Resistant ◽  
Specific Association ◽  
Great Genetic Diversity ◽  
Very High

ABSTRACT Over an 8-year period (1995 to 2002), 86 Enterococcus faecium blood isolates from 84 patients, of which 54 were ampicillin resistant (AREF) and 32 were ampicillin susceptible (ASEF), were studied in a university hospital (1,200 beds; serving a population of 600,000) in Spain, a country characterized by a near-absence of resistance to vancomycin and very high rates of ampicillin resistance among enterococci. Clonal relatedness by pulsed-field gel electrophoresis (PFGE), antibiotic susceptibility, presence of the virulence/epidemicity genes esp Efm and hyl Efm, and identification of purK alleles were studied. A group of isolates was also analyzed by amplified fragment length polymorphism (AFLP) and multilocus sequence typing. Medical charts (30 variables collected) were reviewed for 60/84 patients. ASEF showed high clonal diversity (32 PFGE types, 11 purK alleles, 4 AFLP genogroups), did not harbor putative virulence genes, and had no specific association with hospital acquisition. AREF isolates belonged to a clonal complex (CC) of genetically related strains (purK-1, AFLP genogroup C), occasionally harboring putative virulence traits, and were from patients with particular risk factors. Within this CC, previously associated with vancomycin-resistant E. faecium isolates causing outbreaks worldwide (W. L. Homan et al., J. Clin. Microbiol. 40:1963-1971, 2002), a great genetic diversity of antibiotic resistance and virulence/epidemicity profiles was found. Associations between esp and a >7-day hospital stay and between purK-1, hospital location, and nosocomial acquisition were noted (P < 0.001). These findings reflect the importance of local environmental differences in the evolution of this CC, suggesting that the emergence of vancomycin resistance among AREF strains in Spain may be a question of time.

The Increase of Vancomycin-Resistant Enterococcus Faecium in Urine: A Retrospective Study at University Hospital of Bari

Pharmacophore ◽  
2021 ◽  
Vol 12 (5) ◽  
pp. 11-19
Author(s):  
Stolfa Stefania ◽  
Romanelli Federica ◽  
Ronga Luigi ◽  
Del Prete Raffaele ◽  
Mosca Adriana
Keyword(s):  
Retrospective Study ◽  
Enterococcus Faecium ◽  
University Hospital ◽  
Vancomycin Resistant Enterococcus ◽  
Vancomycin Resistant

scholarly journals Draft Genome Sequence of a Vancomycin-Resistant and Vancomycin-Dependent Enterococcus faecium Isolate

2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Marion Blaschitz ◽  
Sarah Lepuschitz ◽  
Laura Wagner ◽  
Franz Allerberger ◽  
Alexander Indra ◽  
...  
Keyword(s):  
Genome Sequence ◽  
Enterococcus Faecium ◽  
Prolonged Exposure ◽  
Draft Genome ◽  
Vancomycin Resistance ◽  
Draft Genome Sequence ◽  
Nosocomial Pathogens ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Faecium Isolate

Vancomycin-resistant enterococci have emerged as major nosocomial pathogens worldwide. While antimicrobial pressure promotes nosocomial colonization with these enterococci, prolonged exposure to vancomycin may foster the transition from vancomycin resistance to vancomycin dependence. Here, we report the draft genome sequence of a vancomycin-dependent Enterococcus faecium isolate showing partial teicoplanin dependence.

scholarly journals Homologous Recombination within Large Chromosomal Regions Facilitates Acquisition of β-Lactam and Vancomycin Resistance in Enterococcus faecium

2016 ◽  
Vol 60 (10) ◽  
pp. 5777-5786 ◽  
Author(s):  
Mónica García-Solache ◽  
Francois Lebreton ◽  
Robert E. McLaughlin ◽  
James D. Whiteaker ◽  
Michael S. Gilmore ◽  
...  
Keyword(s):  
Enterococcus Faecium ◽  
Genomic Dna ◽  
Large Scale ◽  
Vancomycin Resistance ◽  
Whole Genome ◽  
Whole Genome Analysis ◽  
Single Nucleotide ◽  
Content Type ◽  
Donor Chromosome ◽  
Vancomycin Resistant

ABSTRACTThe transfer of DNA betweenEnterococcus faeciumstrains has been characterized both by the movement of well-defined genetic elements and by the large-scale transfer of genomic DNA fragments. In this work, we report on the whole-genome analysis of transconjugants resulting from mating events between the vancomycin-resistantE. faeciumC68 strain and the vancomycin-susceptible D344RRF strain to discern the mechanism by which the transferred regions enter the recipient chromosome. Vancomycin-resistant transconjugants from five independent matings were analyzed by whole-genome sequencing. In all cases but one, the penicillin binding protein 5 (pbp5) gene and the Tn5382vancomycin resistance transposon were transferred together and replaced the correspondingpbp5region of D344RRF. In one instance, Tn5382inserted independently downstream of the D344RRFpbp5gene. Single nucleotide variant (SNV) analysis suggested that entry of donor DNA into the recipient chromosome occurred by recombination across regions of homology between donor and recipient chromosomes, rather than through insertion sequence-mediated transposition. The transfer of genomic DNA was also associated with the transfer of C68 plasmid pLRM23 and another putative plasmid. Our data are consistent with the initiation of transfer by cointegration of a transferable plasmid with the donor chromosome, with subsequent circularization of the plasmid-chromosome cointegrant in the donor prior to transfer. Entry into the recipient chromosome most commonly occurred across regions of homology between donor and recipient chromosomes.

scholarly journals Emergence of increasing linezolid-resistance in enterococci in a post-outbreak situation with vancomycin-resistantEnterococcus faecium

2007 ◽  
Vol 136 (8) ◽  
pp. 1131-1133 ◽  
Author(s):  
B. SCHULTE ◽  
A. HEININGER ◽  
I. B. AUTENRIETH ◽  
C. WOLZ
Keyword(s):  
Enterococcus Faecium ◽  
Drug Exposure ◽  
University Hospital ◽  
Linezolid Resistance ◽  
Vancomycin Resistant ◽  
Over Time ◽  
Outbreak Situation ◽  
Southwest Germany

SUMMARYDuring 2004 and at the start of 2005 a university hospital in Southwest Germany was affected by an extensive outbreak of vancomycin-resistantEnterococcus faecium(VRE). Although the outbreak was contained, linezolid-resistant enterococci emerged during and after the outbreak as the usage of linezolid became more common. Linezolid resistance was no longer limited to VRE. Nosocomial spread of linezolid-resistant but vancomycin-susceptibleE. faeciumwas detected and these strains also emerged in patients without prior drug exposure. Linezolid should therefore be used with caution and the susceptibility of isolates monitored over time. Isolation precautions and screening of contacts should be considered to avoid spread of resistant isolates.

scholarly journals Failure of VITEK2 to reliably detect vanB- mediated vancomycin resistance in Enterococcus faecium

2020 ◽  
Author(s):  
Sarah V. Walker ◽  
Martina Wolke ◽  
Georg Plum ◽  
Robert E. Weber ◽  
Guido Werner ◽  
...  
Keyword(s):  
Enterococcus Faecium ◽  
Vancomycin Resistance ◽  
Bacterial Suspension ◽  
Initial Growth ◽  
Low Level ◽  
Test Kit ◽  
Before And After ◽  
Vancomycin Resistant ◽  
High Level ◽  
Level Resistance

AbstractObjectivesThe increasing prevalence of vancomycin resistant enterococci (VRE) necessitates a reliable detection of VRE especially for low level resistance mediated by vanB in Enterococcus faecium. In this prospective study we analyzed if vanB mediated vancomycin resistance can be reliably detected by Vitek2.Methods1344 enterococcal isolates from routine clinical specimens were tested by Vitek2 (bioMérieux, Nürtingen, Germany). Additionally, a bacterial suspension (0.5 McFarland) was inoculated on a chromID VRE screening agar (bioMérieux) and incubated for 48 hours. If vancomycin was tested susceptible by Vitek2 but growth was detected on the screening agar a PCR for vanA/vanB was performed (GeneXpert vanA/B test kit, Cepheid, Frankfurt, Germany). MICs of vancomycin susceptible by Vitek but vanA/B positive isolates were determined before and after cultivation in a broth with increasing concentration of vancomycin.Results156/492 of E. faecium were VRE, predominantly vanB (87.0%) of which 14 were not identified as VRE by Vitek2 (sensitivity 91.0%). The majority (9/14) demonstrated high-level MICs by broth dilution. Even after exposure to increasing vancomycin concentrations MICs remained nearly identical. Three of the undetected isolates demonstrated initial growth on chromID VRE, after the vancomycin exposure additional 7 isolates demonstrated growth on chromID VRE.ConclusionsVitek2 fails to detect vanB mediated vancomycin resistance consistently, especially but not limited to low-level resistance. As this may lead to treatment failure and further dissemination of vanB VRE, additional methods (e.g. culture on VRE screening agar or PCR) are necessary to reliably identify vanB-positive enterococci in clinical routine.

scholarly journals Identification of VanN-Type Vancomycin Resistance in an Enterococcus faecium Isolate from Chicken Meat in Japan

2012 ◽  
Vol 56 (12) ◽  
pp. 6389-6392 ◽  
Author(s):  
Takahiro Nomura ◽  
Koichi Tanimoto ◽  
Keigo Shibayama ◽  
Yoshichika Arakawa ◽  
Shuhei Fujimoto ◽  
...  
Keyword(s):  
Enterococcus Faecium ◽  
Gel Electrophoresis ◽  
Vancomycin Resistance ◽  
Pulsed Field Gel Electrophoresis ◽  
Chicken Meat ◽  
Large Plasmid ◽  
Content Type ◽  
Vancomycin Resistant ◽  
Faecium Isolate ◽  
Level Resistance

ABSTRACTFive VanN-type vancomycin-resistantEnterococcus faeciumstrains were isolated from a sample of domestic chicken meat in Japan. All isolates showed low-level resistance to vancomycin (MIC, 12 mg/liter) and had the same pulsed-field gel electrophoresis profile. The vancomycin resistance was encoded on a large plasmid (160 kbp) and was expressed constitutively. The VanN-type resistance operon was identical to the first resistance operon to be reported, with the exception of a 1-bp deletion invanTNand a 1-bp substitution invanSN.

scholarly journals Intraspecies Genomic Groups in Enterococcus faecium and Their Correlation with Origin and Pathogenicity

2002 ◽  
Vol 68 (3) ◽  
pp. 1381-1391 ◽  
Author(s):  
Marc Vancanneyt ◽  
Angiolella Lombardi ◽  
Christian Andrighetto ◽  
Edo Knijff ◽  
Sandra Torriani ◽  
...  
Keyword(s):  
Dna Hybridization ◽  
Enterococcus Faecium ◽  
Fragment Length Polymorphism ◽  
Random Amplified Polymorphic Dna ◽  
Clinical Samples ◽  
Pfge Analysis ◽  
Group I ◽  
Dna Reassociation ◽  
Rapd Pcr ◽  
Vancomycin Resistant

ABSTRACT Seventy-eight Enterococcus faecium strains from various sources were characterized by random amplified polymorphic DNA (RAPD)-PCR, amplified fragment length polymorphism (AFLP), and pulsed-field gel electrophoresis (PFGE) analysis of SmaI restriction patterns. Two main genomic groups (I and II) were obtained in both RAPD-PCR and AFLP analyses. DNA-DNA hybridization values between representative strains of both groups demonstrated a mean DNA-DNA reassociation level of 71%. PFGE analysis revealed high genetic strain diversity within the two genomic groups. Only group I contained strains originating from human clinical samples or strains that were vancomycin-resistant or beta-hemolytic. No differentiating phenotypic features between groups I and II were found using the rapid ID 32 STREP system. The two groups could be further subdivided into, respectively, four and three subclusters in both RAPD-PCR and AFLP analyses, and a high correlation was seen between the subclusters generated by these two methods. Subclusters of group I were to some extent correlated with origin, pathogenicity, and bacteriocinogeny of the strains. Host specificity of E. faecium strains was not confirmed.

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