scholarly journals Novel genomic islands and a new vanD-subtype in the first sporadic VanD-type vancomycin resistant enterococci in Norway

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255187
Author(s):  
Mushtaq T. S. AL Rubaye ◽  
Jessin Janice ◽  
Jørgen Vildershøj Bjørnholt ◽  
Aleksandra Jakovljev ◽  
Maria Elisabeth Hultström ◽  
...  
Keyword(s):  
Gene Clusters ◽  
Vancomycin Resistance ◽  
Genomic Islands ◽  
Vancomycin Resistant Enterococci ◽  
Chromosomal Site ◽  
Enterococcus Casseliflavus ◽  
Temporal Occurrence ◽  
Vancomycin Resistant ◽  
High Level

Background Vancomycin-resistant enterococci (VRE) represent several types of transferable vancomycin resistance gene clusters. The vanD type, associated with moderate to high level vancomycin resistance, has only sporadically been described in clinical isolates. The aim of this study was to perform a genetic characterization of the first VanD-type VRE strains detected in Norway. Methods The VanD-type VRE-strains (n = 6) from two patient cases were examined by antimicrobial susceptibility testing and whole genome sequencing (WGS) to uncover Van-phenotype, strain phylogeny, the vanD gene clusters, and their genetic surroundings. The putative transferability of vanD was examined by circularization PCR and filter mating. Results The VanD-type Enterococcus faecium (n = 4) and Enterococcus casseliflavus (n = 2) strains recovered from two cases (A and B), expressed moderate to high level vancomycin resistance (MIC 64—>256 mg/L) and various levels of teicoplanin susceptibility (MIC 2—>256 mg/L). WGS analyses revealed phylogenetically different E. faecium strains (A1, A2, and A3 of case A and B1 from case B) as well as vanD gene clusters located on different novel genomic islands (GIs). The E. casseliflavus strains (B2 and B3 of case B) were not clonally related, but harbored nearly identical novel GIs. The vanD cluster of case B strains represents a novel vanD-subtype. All the vanD-GIs were integrated at the same chromosomal site and contained genes consistent with a Clostridiales origin. Circular forms of the vanD-GIs were detected in all strains except B1. Transfer of vanD to an E. faecium recipient was unsuccessful. Conclusions We describe the first VanD-type E. casseliflavus strains, a novel vanD-subtype, and three novel vanD-GIs with a genetic content consistent with a Clostridiales order origin. Despite temporal occurrence, case A and B E. faecium strains were phylogenetically diverse and harbored different vanD subtypes and vanD-GIs.

scholarly journals High-level vancomycin-resistant enterococci causing hospital infections

1989 ◽  
Vol 103 (1) ◽  
pp. 173-181 ◽  
Author(s):  
A. H. C. Uttley ◽  
R. C. George ◽  
J. Naidoo ◽  
N. Woodford ◽  
A. P. Johnson ◽  
...  
Keyword(s):  
Plasmid Dna ◽  
Vancomycin Resistance ◽  
Recipient Strain ◽  
Hospital Infections ◽  
Minimal Inhibitory Concentrations ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Many Sources ◽  
High Level ◽  
Level Resistance

SUMMARYNosocomial infection or colonization due to enterococci with high-level resistance to vancomycin (minimal inhibitory concentrations [MICs] between 64 and > 2000 mg/L) has occurred in 41 patients with renal disease. These vancomycin-resistant enterococci were cultured from many sources including blood. All but one strain contained one or more plasmids ranging in molecular weight from 1·0 to 40 Megadaltons (MDa). Vancomycin resistance was transferable by conjugation to a susceptible recipient strain ofEnterococcus faecalisbut this was not always associated with plasmid DNA. The emergence of transferable high-level vancomycin resistance in enterococci causing significant clinical infections is of particular importance since vancomycin is widely regarded as a reserve drug for the management of infections with multi-resistant Gram-positive organisms.

scholarly journals Molecular Characterization of Vancomycin-Resistant Enterococci from Hospitalized Patients and Poultry Products in The Netherlands

1998 ◽  
Vol 36 (7) ◽  
pp. 1927-1932 ◽  
Author(s):  
Nicole van den Braak ◽  
Alex van Belkum ◽  
Marrit van Keulen ◽  
John Vliegenthart ◽  
Henri A. Verbrugh ◽  
...  
Keyword(s):  
Intergenic Region ◽  
Bacterial Flora ◽  
Structure Mapping ◽  
Poultry Products ◽  
Vancomycin Resistant Enterococci ◽  
Genetic Overlap ◽  
Intergenic Regions ◽  
Vancomycin Resistant ◽  
High Level

Vancomycin-resistant enterococci (VRE) pose an emerging health risk, but little is known about the precise epidemiology of the genes coding for vancomycin resistance. To determine whether the bacterial flora of consumer poultry serves as a gene reservoir, the level of contamination of poultry products with VRE was determined. VRE were genotyped by pulsed-field gel electrophoresis (PFGE), and transposon structure mapping was done by PCR. ThevanX-vanY intergenic regions of several strains were further analyzed by sequencing. A total of 242 of 305 (79%) poultry products were found to be contaminated with VRE. Of these VRE, 142 (59%) were high-level-vancomycin-resistant Enterococcus faecium strains (VREF). PFGE revealed extensive VREF heterogeneity. Two genotypes were found nationwide on multiple occasions: type A (22 of 142 VREF [15%]) and type B (14 of 142 VREF [10%]). No PFGE-deduced genetic overlap was found when VREF from humans were compared with VREF from poultry. TwovanA transposon types were identified among poultry strains. In 59 of 142 (42%) of the poultry VREF, the size of the intergenic region between vanX and vanY was ∼1,300 bp. This transposon type was not found in human VREF. In contrast, all human strains and 83 of 142 (58%) of the poultry VREF contained an intergenic region 543 bp in size. Sequencing of this 543-bp intergenic vanX-vanY region demonstrated full sequence conservation. Though preliminary, these data suggest that dissemination of the resistance genes carried on transposable elements may be of greater importance than clonal dissemination of resistant strains. This observation is important for developing strategies to control the spread of glycopeptide resistance.

Characterization of Vancomycin-Resistant Enterococci Isolated from Stools and Their Acquisition of Vancomycin Resistance

2010 ◽  
Vol 40 (4) ◽  
pp. 179 ◽  
Author(s):  
Hee Jeong Kim ◽  
Heun Young Kwon ◽  
Kang Lim Kim ◽  
Hyo Jin Lee ◽  
Hyun Jung Jo ◽  
...  
Keyword(s):  
Vancomycin Resistance ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant

scholarly journals Vancomycin-Resistant Enterococci in Humans and Imported Chickens in Japan

2002 ◽  
Vol 68 (12) ◽  
pp. 6457-6461 ◽  
Author(s):  
Yoshiyuki Ozawa ◽  
Koichi Tanimoto ◽  
Takahiro Nomura ◽  
Masao Yoshinaga ◽  
Yoshichika Arakawa ◽  
...  
Keyword(s):  
Amino Acid ◽  
Gene Sequence ◽  
Vancomycin Resistance ◽  
Terminal Region ◽  
Resistance Determinant ◽  
Amino Acid Substitutions ◽  
Low Level ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
High Level

ABSTRACT The phenotypes and genotypes of 22 VanA-type vancomycin-resistant enterococci that had been isolated in Japan were examined. The VanA resistance determinant was plasmid mediated in each of the 22 strains. Of the 22 strains, 8 were isolated from different patients and 11 and 3 were obtained from different samples of chickens imported from Thailand and France, respectively. Three of the strains that were isolated from patients and the 11 strains isolated from the Thai chickens showed high-level vancomycin resistance (MICs, 512 to 1,024 μg/ml) and low-level teicoplanin resistance (MICs, 0.5 to 4 μg/ml). Each of these strains had three amino acid substitutions in the N-terminal region of the deduced VanS sequence. L50 was converted to V, E54 was converted to Q, and Q69 was converted to H compared to the vanS gene sequence of Tn1546.

Prevalence and characterization of vancomycin-resistant enterococci in chicken intestines and humans of korea

2004 ◽  
Vol 27 (2) ◽  
pp. 246-253 ◽  
Author(s):  
Chi Nam Seong ◽  
Eun Sook Shim ◽  
Shin Moo Kim ◽  
Jin Cheol Yoo
Keyword(s):  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant

scholarly journals Emergence and spread of vancomycin resistance among enterococci in Europe

2008 ◽  
Vol 13 (47) ◽  
Author(s):  
G Werner ◽  
T M Coque ◽  
A M Hammerum ◽  
R Hope ◽  
W Hryniewicz ◽  
...  
Keyword(s):  
Population Analysis ◽  
Vancomycin Resistance ◽  
Vancomycin Resistant Enterococcus ◽  
Phenotypic Marker ◽  
Vancomycin Resistant Enterococci ◽  
Distinct Subpopulation ◽  
Typing Methods ◽  
Vancomycin Resistant ◽  
Hospital Acquired ◽  
Animal Strains

Vancomycin-resistant enterococci (VRE) first appeared in the late 1980s in a few European countries. Nowadays, six types of acquired vancomycin resistance in enterococci are known; however, only VanA and to a lesser extent VanB are widely prevalent. Various genes encode acquired vancomycin resistance and these are typically associated with mobile genetic elements which allow resistance to spread clonally and laterally. The major reservoir of acquired vancomycin resistance is Enterococcus faecium; vancomycin-resistant Enterococcus faecalis are still rare. Population analysis of E. faecium has revealed a distinct subpopulation of hospital-acquired strain types, which can be differentiated by molecular typing methods (MLVA, MLST) from human commensal and animal strains. Hospital-acquired E. faecium have additional genomic content (accessory genome) including several factors known or supposed to be virulence-associated. Acquired ampicillin resistance is a major phenotypic marker of hospital-acquired E. faecium in Europe and experience has shown that it often precedes increasing rates of VRE with a delay of several years. Several factors are known to promote VRE colonisation and transmission; however, despite having populations with similar predispositions and preconditions, rates of VRE vary all over Europe.

PREVALENCE OF HIGH LEVEL AMINOGLYCOSIDE RESISTANCE AND VANCOMYCIN RESISTANT ENTEROCOCCI IN ENTEROCOCCAL ISOLATES IN A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 3-5
Author(s):  
Sunita Agarwal ◽  
Nazneen Pathan ◽  
Shivra Batra ◽  
Rajni Sharma
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tertiary Care ◽  
Automated System ◽  
Care Hospital ◽  
Enterococcus Species ◽  
Aminoglycoside Resistance ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
High Level

Introduction: The emergence of High Level Aminoglycoside Resistance (Resistant to Gentamycin and Streptomycin) and Vancomycin Resistant Enterococci among Indoor and Intensive Care Unit admitted patient presents a serious challenge for clinicians. Objective: To determine Enterococcal burden in blood and urine specimens and to detect the prevalence of High Level Aminoglycoside Resistance and Vancomycin Resistant Enterococci. Material & Methods: One hundred ten Enterococci were isolated from blood and urine samples and processed according to standard laboratory protocol. Species identication and sensitivity was done using the VITEK 2 automated system (Biomerieux France) with the cards GPID and AST 67 respectively. Results: Out of 110 Enterococci isolates, 36 were from blood and 74 from urine were detected. Different Species isolated were Enterococcal faecium (59%), Enterococcal faecalis (34%), Enterococcal rafnosus (2.7%), Enterococcal gallinarum (1.8%), Enterococcal casseliavus (0.9%) and Enterococcal duran (0.9%).Out of 36 blood isolates, 14 (38%) were found to be both High Level Gentamycin Resistant (HLGR) & High Level Streptomycin Resistant (HLSR), 10 (27%) were only HLGR and 8 (22%) were only HLSR. 20 strain (55%) of Enterococcus species isolated in blood were VRE. All VRE strains were found to be resistant to both aminoglycosides ( HLAR).Among the 74 urinary isolates, 24 (34%) were found to be both HLGR & HLSR, only HLGR was observed in 20 (27%) and HLSR was observed in 11 (14%) isolates. 24 strains (34%) of Enterococcus species were found to be vancomycin resistant in urine. 23 strains out of 24 were resistant to high level of aminoglycosides. Conclusion: The prevalence of HLAR and VRE is very high among Enterococcus specimens from indoor/ intensive care unit patients. Early species identication and antibiotic sensitivity result can help in better clinical outcome.

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