Increase of vancomycin-resistant Enterococcus faecium strain type ST117 CT71 at Charité - Universitätsmedizin Berlin, 2008 to 2018

Abstract In addition to an overall rise in vancomycin-resistant Enterococcus faecium (VREfm), an increase in certain other strain types has been reported in Germany over the past few years. Outbreak analyses at Charité - Universitätsmedizin Berlin revealed the frequent occurrence of VREfm ST117 CT71 isolates in 2017 and 2018. To investigate whether ST117 CT71 have emerged in recent years or whether these strains have been circulating for a longer time, we retrospectively analyzed non-outbreak strains that occurred between 2008 and 2018 to identify frequent sequence types (STs) and cluster types (CTs). Methods In total, 120 VREfm isolates obtained from clinical and surveillance cultures from the years 2008, 2013, 2015, and 2018 were analyzed. Thirty isolates per year comprising the first 7 to 8 non-outbreak isolates of each quarter of the respective year were sequenced using whole genome sequencing. MLST and cgMLST were determined as well as resistance genes and virulence factors. Risk factors for VREfm ST117 were analyzed in a multivariable analysis with patient characteristics as possible confounders. Results The percentage of VREfm of type ST117 increased from 17% in 2008 to 57% in 2018 (p=0.012). In 2008, vanA genotype accounted for 80% of all ST117 isolates compared to 6% in 2018. VanB CT71 first appeared in 2018 and predominated over all other ST117 at 43% (p<0.0001). The set of resistance genes and virulence factors in CT71 (msrC, efmA, ermB, dfrG, and aac(6')-Ii) and virulence factors (acm, esp, hyl, ecbA and sgrA) was also found in other ST117 non-CT71 strains, mainly in CT36. The study population did not differ among the different calendar years analyzed in terms of age, gender, length of stay, or ward type (each p>0.2). Conclusion This study revealed an increase in ST117 strains from 2008 to 2018, accompanied by a shift toward CT71 strains with the vanB genotype in 2018. We did not detect resistance or virulence traits in CT71 that could confer survival advantage compared to other CTs among ST117 strains. To date, it is not clear why ST117 and in particular strain type ST117 CT71 predominates over other strains.

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Increase of vancomycin-resistant Enterococcus faecium strain type ST117 CT71 at Charité - Universitätsmedizin Berlin, 2008 to 2018

10.21203/rs.2.17129/v2 ◽

2020 ◽

Author(s):

Anna Weber ◽

Friederike Maechler ◽

Frank Schwab ◽

Petra Gastmeier ◽

Axel Kola

Keyword(s):

Virulence Factors ◽

Resistance Genes ◽

Enterococcus Faecium ◽

Multivariable Analysis ◽

Patient Characteristics ◽

Vancomycin Resistant Enterococcus ◽

The Past ◽

Study Population ◽

Strain Type ◽

Vancomycin Resistant

Abstract Background: In addition to an overall rise in vancomycin-resistant Enterococcus faecium (VREfm), an increase in certain strain types marked by sequence type (ST) and cluster type (CT) has been reported in Germany over the past few years. Outbreak analyses at Charité - Universitätsmedizin Berlin revealed the frequent occurrence of VREfm ST117 CT71 isolates in 2017 and 2018. To investigate whether ST117 CT71 have emerged in recent years or whether these strains have been circulating for a longer time, we retrospectively analyzed non-outbreak strains that occurred between 2008 and 2018 to identify frequent STs and CTs.Methods: In total, 120 VREfm isolates obtained from clinical and surveillance cultures from the years 2008, 2013, 2015, and 2018 were analyzed. Thirty isolates per year comprising the first 7 - 8 non-outbreak isolates of each quarter of the respective year were sequenced using whole genome sequencing. MLST and cgMLST were determined as well as resistance genes and virulence factors. Risk factors for VREfm ST117 were analyzed in a multivariable analysis with patient characteristics as possible confounders. Results: The percentage of VREfm of type ST117 increased from 17% in 2008 to 57% in 2018 (p=0.012). In 2008, vanA genotype accounted for 80% of all ST117 isolates compared to 6% in 2018. VanB CT71 first appeared in 2018 and predominated over all other ST117 at 43% (p<0.0001). The set of resistance genes (msrC, efmA, ermB, dfrG, aac(6')-Ii, gyrA, parC and pbp5) and virulence factors (acm, esp, hylEfm, ecbA and sgrA) in CT71 was also found in other ST117 non-CT71 strains, mainly in CT36. The study population did not differ among the different calendar years analyzed in terms of age, gender, length of stay, or ward type (each p>0.2).Conclusion: This study revealed an increase in ST117 strains from 2008 to 2018, accompanied by a shift toward CT71 strains with the vanB genotype in 2018. We did not detect resistance or virulence traits in CT71 that could confer survival advantage compared to other CTs among ST117 strains. To date, it is not clear why ST117 and in particular strain type ST117 CT71 predominates over other strains.

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Identification and characterization of IS1476, an insertion sequence-like element that disrupts VanY function in a vancomycin-resistant Enterococcus faecium strain.

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.41.8.1805 ◽

1997 ◽

Vol 41 (8) ◽

pp. 1805-1807 ◽

Cited By ~ 27

Author(s):

M G MacKinnon ◽

M A Drebot ◽

G J Tyrrell

Keyword(s):

Resistance Gene ◽

Enterococcus Faecium ◽

Insertion Sequence ◽

Vancomycin Resistant Enterococcus ◽

Detection Strategy ◽

Vancomycin Resistant Enterococci ◽

Vancomycin Resistant ◽

Identification And Characterization ◽

Faecium Strain

The vanY gene of vancomycin-resistant enterococci encodes a D,D-carboxypeptidase. By using a PCR detection strategy, a VanA Enterococcus faecium clinical isolate was found to have an insertion sequence (IS)-like element designated IS1476 in vanY. The activity of the VanY D,D-carboxypeptidase in this isolate was decreased in a fluorometric fluoraldehyde o-phthalaldehyde assay with diacetyl-L-Lys-D-Ala-D-Ala as the substrate. This, to our knowledge, is the first report of an IS-like element in a vancomycin resistance gene.

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Vancomycin-Resistant Enterococcus faecium Strain Carrying the vanB2 Gene Variant in a Polish Hospital

Journal of Clinical Microbiology ◽

10.1128/jcm.39.2.811-815.2001 ◽

2001 ◽

Vol 39 (2) ◽

pp. 811-815 ◽

Cited By ~ 6

Author(s):

M. Kawalec ◽

M. Gniadkowski ◽

U. Zielinska ◽

W. Hryniewicz

Keyword(s):

Enterococcus Faecium ◽

Vancomycin Resistant Enterococcus ◽

Gene Variant ◽

Vancomycin Resistant ◽

Faecium Strain

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Clonal Spread of a Vancomycin-Resistant Enterococcus faecium Strain among Bloodstream-Infecting Isolates in Italy

Journal of Clinical Microbiology ◽

10.1128/jcm.43.4.1575-1580.2005 ◽

2005 ◽

Vol 43 (4) ◽

pp. 1575-1580 ◽

Cited By ~ 42

Author(s):

L. Stampone ◽

M. Del Grosso ◽

D. Boccia ◽

A. Pantosti

Keyword(s):

Enterococcus Faecium ◽

Vancomycin Resistant Enterococcus ◽

Vancomycin Resistant ◽

Clonal Spread ◽

Faecium Strain

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Characterization of Bacteriophage against Enterococcus faecium Resistant to Vancomycin Isolated from Chicken Skin

Asian Food Science Journal ◽

10.9734/afsj/2019/v10i130026 ◽

2019 ◽

pp. 1-14

Author(s):

Hazzierah Syaffieqah An Nadiah Azlan ◽

Muhajir Hamid ◽

Adelene Ai-Lian Song

Keyword(s):

Latent Period ◽

Growth Kinetics ◽

Enterococcus Faecium ◽

Burst Size ◽

Single Step ◽

Vancomycin Resistant Enterococcus ◽

Chicken Skin ◽

Step Growth ◽

Vancomycin Resistant ◽

Faecium Strain

Aims: To characterize bacteriophages with strong in vitro lytic activity against vancomycin resistant Enterococcus faecium before testing on the chicken skin for their efficacy. Study Design: An experimental was carried out to characterize two isolated bacteriophages against Enterococcus faecium and test for their efficacy on chicken skin. Study Place: The study was carried out in Laboratory of Vaccine and Immunotherapeutics, Institue of Bioscience, Universiti Putra Malaysia in Selangor, which is the most populous state in Malaysia. Methodology: Two host specific lytic phages against vancomycin resistant Enterococcus faecium strain FM8, designated as FM8-P1 and FM8-P2 were physiological characterized. This includes determination of their adsorption rate, multiplicity of infection, and single step growth kinetics. The optimum pH and temperature for both bacteriophages activity were also determined before tested on chicken skin at 4°C and 25°C, which represent chiller and room temperature in poultry production line. Results: Based on the result of single-step growth kinetics, the latent period of FM8-P1 was 35 min with a burst size of 460 particles per infected cells, while FM8-P2 has a shorter latent period (20 min) but a smaller burst size of 60 particles. The highest adsorption rate for FM8-P1 was 83% and FM8-P2 was 90% at 2 min and 4 min respectively. Both bacteriophages also exihibited a wide range of pH and temperature for their activity. Conclusion: The specificity, lytic activity and stability of FM8-P1 and FM8-P2 emphasized their potential in effectively eliminating the vancomycin resistant Enterococcus faecium strain FM8. However, further works are required to validate their in situ reliability.

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Increase of vancomycin-resistant Enterococcus faecium strain type ST117 CT71 at Charité - Universitätsmedizin Berlin, 2008 to 2018

10.21203/rs.2.17129/v3 ◽

2020 ◽

Author(s):

Anna Weber ◽

Friederike Maechler ◽

Frank Schwab ◽

Petra Gastmeier ◽

Axel Kola

Keyword(s):

Virulence Factors ◽

Resistance Genes ◽

Enterococcus Faecium ◽

Multivariable Analysis ◽

Patient Characteristics ◽

Vancomycin Resistant Enterococcus ◽

The Past ◽

Study Population ◽

Strain Type ◽

Vancomycin Resistant

Abstract Background: In addition to an overall rise in vancomycin-resistant Enterococcus faecium (VREfm), an increase in certain strain types marked by sequence type (ST) and cluster type (CT) has been reported in Germany over the past few years. Outbreak analyses at Charité - Universitätsmedizin Berlin revealed the frequent occurrence of VREfm ST117 CT71 isolates in 2017 and 2018. To investigate whether ST117 CT71 have emerged in recent years or whether these strains have been circulating for a longer time, we retrospectively analyzed non-outbreak strains that occurred between 2008 and 2018 to identify frequent STs and CTs.Methods: In total, 120 VREfm isolates obtained from clinical and surveillance cultures from the years 2008, 2013, 2015, and 2018 were analyzed. Thirty isolates per year comprising the first 7 - 8 non-outbreak isolates of each quarter of the respective year were sequenced using whole genome sequencing. MLST and cgMLST were determined as well as resistance genes and virulence factors. Risk factors for VREfm ST117 were analyzed in a multivariable analysis with patient characteristics as possible confounders. Results: The percentage of VREfm of type ST117 increased from 17% in 2008 to 57% in 2018 (p=0.012). In 2008, vanA genotype accounted for 80% of all ST117 isolates compared to 6% in 2018. VanB CT71 first appeared in 2018 and predominated over all other ST117 at 43% (p<0.0001). The set of resistance genes (msrC, efmA, erm(B), dfrG, aac(6')-Ii, gyrA, parC and pbp5) and virulence factors (acm, esp, hylEfm, ecbA and sgrA) in CT71 was also found in other ST117 non-CT71 strains, mainly in CT36. The study population did not differ among the different calendar years analyzed in terms of age, gender, length of stay, or ward type (each p>0.2).Conclusion: This study revealed an increase in ST117 strains from 2008 to 2018, accompanied by a shift toward CT71 strains with the vanB genotype in 2018. We did not detect resistance or virulence traits in CT71 that could confer survival advantage compared to other CTs among ST117 strains. To date, it is not clear why ST117 and in particular strain type ST117 CT71 predominates over other strains.

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