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Role of Horizontal Transfer of the Transposon Tn1546 in the Nosocomial Spread of vanA Vancomycin-Resistant Enterococci at a Tertiary Care Hospital in Korea

Published online by Cambridge University Press:  21 June 2016

Soo Jin Yoo ,
Heungsup Sung ,
Young-Uk Cho ,
Mi-Na Kim ,
Chik Hyun Pai  and
Yang Soo Kim
Soo Jin Yoo
Affiliation:
Departments of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea Department of Laboratory Medicine, Sangye Paik Hospital, Inje University College of Medicine, Seoul, Korea
Heungsup Sung
Affiliation:
Departments of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
Young-Uk Cho
Affiliation:
Departments of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
Mi-Na Kim*
Affiliation:
Departments of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
Chik Hyun Pai
Affiliation:
Departments of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
Yang Soo Kim
Affiliation:
Internal Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
*
Department of Laboratory Medicine, Asan Medical Center, 388-1 Pungnap-dong, Songpa-gu, Seoul, Korea138-736, (mnkim@amc.seoul.kr)
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Extract

Objective:

To investigate the epidemiologic characteristics of vancomycin-resistant enterococci (VRE) infection.

Design.

An epidemiologic description by means of chromosomal DNA fingerprinting and transposon typing.

Setting.

A 2,200-bed tertiary care hospital in Korea.

Patients.

First VRE isolates were obtained from patients hospitalized from April 1997 to December 2001.

Interventions.

The van genotypes of isolates were identified by means of multiplex polymerase chain reaction (PCR). The macro-restriction patterns of chromosomal DNA were determined by pulsed-field gel electrophoresis (PFGE). The transposon Tn1546was typed by means of 2 sets of long PCR restriction fragment-length polymorphism analysis, which were ClaI restriction of a 10.4-kb region from orf1 to vanZ and DdeI restriction of a 4.4-kb region from vanR to vanX.

Results.

VRE isolates were recovered from 215 patients. All were vanA genotype. PFGE analysis of the 215 isolates showed 172 types, including 21 clusters composed of 64 isolates and 151 types of as many isolates. Each type was composed of 2-10 isolates; the isolates within each PFGE cluster were detected within a 10-month period and mostly shared a transposon type. Transposon typing classified 169 strains into 15 types and 158 strains belonged to 4 major transposon clusters. Each of these 4 transposon clusters was isolated from patients treated in 5-22 different wards during a 31-52 month period and consisted of 9-80 PFGE types. Each of the other 11 types were found in only one strain.

Conclusions.

Our findings suggest that the horizontal transfer of Tn1546 has a major role in the nosocomial spread of vanA VRE. Clonal spread of VRE seemed to contribute to short-term dissemination in limited areas.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 27 , Issue 10 , October 2006 , pp. 1081 - 1087
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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