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Molecular Characterization of Vancomycin-Resistant Enterococci from Clinical and Surveillance Specimens

Published online by Cambridge University Press:  21 June 2016

Ji Young Huh
Affiliation:
Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Ajou University School of Medicine, Suwon, South Korea
Wee Gyo Lee*
Affiliation:
Departments of Laboratory Medicine, Ajou University School of Medicine, Suwon, South Korea
Hye Young Jin
Affiliation:
Hospital Infection Control, Ajou University School of Medicine, Suwon, South Korea
*
Department of Laboratory Medicine, Ajou University Hospital, San 5, Wonchun-Dong, Youngtong-Gu, Suwon 442-749, South Korea, (weegyo@ajou.ac.kr)

Extract

Objective:

To compare the molecular characteristics of infection-derived (ID) isolates and intestinal colonization–derived (ICD) isolates of vancomycin-resistant enterococci (VRE) recovered from hospitalized patients.

Design.

A 12-month prospective cohort study.

Setting.

A 1,000-bed teaching facility.

Methods.

From January through December 2004, a total of 30 pairs of vanA-containing enterococcal isolates were collected from patients admitted to a teaching hospital in South Korea. Each pair comprised an ID and an ICD VRE isolate from the same patient. All VRE isolates were investigated on the basis of SmaI-restricted pulsed-field gel electrophoresis (PFGE) pattern, Tn1546type, and presence of the esp gene, including A and C repeat number variation.

Results.

Members of 19 pairs (63%) of VRE isolates were genetically indistinguishable from each other. The 11 patients for whom the molecular characteristics of the ID isolates differed from those of the ICD isolates had longer durations of hospitalization and intensive care unit (ICU) stay, compared with the other 19 patients.

Conclusions.

These findings suggest the longer durations of hospitalization and ICU stay may be possible risk factors for colonization with multiple clones of VRE.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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References

1. Klare, I, Konstabel, C, Badstubner, D, Werner, G, Witte, W. Occurrence and spread of antibiotic resistances in Enterococcus faecium . Int J Food Microbiol 2003; 88:269290.Google Scholar
2. Cetinkaya, Y, Falk, P, Mayhall, CG. Vancomycin-resistant enterococci. Clin Microbiol Rev 2000; 13:686707.Google Scholar
3. Malathum, K, Murray, BE. Vancomycin-resistant enterococci: recent advances in genetics, epidemiology and therapeutic options. Drug Resist Updat 1999; 2:224243.Google Scholar
4. Woodford, N, Adebiyi, AM, Palepou, MF, Cookson, BD. Diversity of VanA glycopeptide resistance elements in enterococci from humans and non-human sources. Antimicrob Agents Chemother 1998; 42:502508.Google Scholar
5. Simonsen, GS, Myhre, MR, Dahl, KH, Olsvik, Ø, Sundsfjord, A. Typeability of Tn1546-like elements in vancomycin-resistant enterococci using long-range PCRs and specific analysis of polymorphic regions. Microb Drug Resist 2000; 6:4957.Google Scholar
6. Schouten, MA, Willems, RJ, Kraak, WA, Top, J, Hoogkamp-Korstanje, JA, Voss, A. Molecular analysis of Tn1546-like elements in vancomycin-resistant enterococci isolated from patients in Europe shows geographic transposon type clustering. Antimicrob Agents Chemother 2001; 45:986989.Google Scholar
7. Stobberingh, E, van den Bogaard, A, London, N, Driessen, C, Top, J, Willems, R. Enterococci with glycopeptide resistance in turkeys, turkey farmers, turkey slaughterers, and (sub)urban residents in the south of The Netherlands: evidence for transmission of vancomycin resistance from animals to humans? Antimicrob Agents Chemother 1999; 43:22152221.Google Scholar
8. Shankar, V, Baghdayan, AS, Huycke, MM, Lindahl, G, Gilmore, MS. Infection-derived Enterococcus faecalis strains are enriched in esp, a gene encoding a novel surface protein. Infect Immun 1999; 67:193200.Google Scholar
9. Eaton, TJ, Gasson, MJ. A variant enterococcal surface protein Esp(fm) in Enterococcus faecium; distribution among food, commensal, medical, and environmental isolates. FEMS Microbiol Lett 2002; 216:269275.Google Scholar
10. Patel, R. Clinical impact of vancomycin-resistant enterococci. J Antimicrob Chemother 2003; 51(Suppl 3):iii1321.Google Scholar
11. Arthur, M, Molinas, C, Depardieu, F, Courvalin, P. Characterization of Tn1546, a Tn3-related transposon conferring glycopeptide resistance by synthesis of depsipeptide peptidoglycan precursors in Enterococcus faecium BM4147. J Bacteriol 1993; 175:117127.Google Scholar
12. Lee, WG, Jernigan, JA, Rasheed, JK, Anderson, GJ, Tenover, FC. Possible horizontal transfer of the vanB2 gene among genetically diverse strains of vancomycin-resistant Enterococcus faecium in a Korean hospital. J Clin Microbiol 2001; 39:11651168.Google Scholar
13. Tenover, FC, Arbeit, RD, Goering, RV, et al. Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 1995; 33:22332239.CrossRefGoogle ScholarPubMed
14. Leavis, H, Top, J, Shankar, N, et al. A novel putative enterococcal pathogenicity island linked to the esp virulence gene of Enterococcus faecium and associated with epidemicity. J Bacteriol 2004; 186:672682.Google Scholar
15. Gardiner, D, Murphey, S, Ossman, E, Jungkind, D. Prevalence and acquisition of vancomycin-resistant enterococci in a medical intensive care unit. Infect Control Hosp Epidemiol 2002; 23:466468.Google Scholar
16. Warren, DK, Kollef, MH, Seiler, SM, Fridkin, SK, Fraser, VJ. The epidemiology of vancomycin-resistant enterococcus colonization in a medical intensive care unit. Infect Control Hosp Epidemiol 2003; 24:257263.Google Scholar
17. Henning, KJ, Delencastre, H, Eagan, J, et al. Vancomycin-resistant Enterococcus faecium on a pediatric oncology ward: duration of stool shedding and incidence of clinical infection. Pediatr Infect Dis J 1996; 15:848854.Google Scholar
18. Patel, R, Allen, SL, Manahan, JM, et al. Natural history of vancomycin-resistant enterococcal colonization in liver and kidney transplant recipients. Liver Transpl 2001; 7:2731.Google Scholar
19. Shankar, N, Lockatell, CV, Baghdayan, AS, Drachenberg, C, Gilmore, MS, Johnson, DE. Role of Enterococcus faecalis surface protein Esp in the pathogenesis of ascending urinary tract infection. Infect Immun 2001; 69:43664372.Google Scholar
20. Willems, RJ, Homan, W, Top, J, et al. Variant esp gene as a marker of a distinct genetic lineage of vancomycin-resistant Enterococcus faecium spreading in hospitals. Lancet 2001; 357:853855.Google Scholar