Vancomycin-resistant Enterococcus spp. (VRE) were isolated from sewage and chicken feces but not from other animal fecal sources (dog, cow, and pig) or from surface waters tested. VRE from hospital wastewater were resistant to >20 g of vancomycin/ml and possessed the vanA gene. VRE from residential wastewater and chicken feces were resistant to 3 to 5 g of vancomycin/ml and possessed the vanC gene.Vancomycin resistance in Enterococcus species is becoming a major concern in clinical settings as the rate of occurrence of vancomycin-resistant Enterococcus spp. (VRE) implicated in disease increases. For example, by 1999 the incidence of VREmediated nosocomial infections in intensive care units had increased 43% from that of the period of 1994 to 1998 (23). Enterococcus faecalis and E. faecium are reported more frequently as etiological agents of disease than are other enterococci (14, 15), but other species, such as E. avium (25), occasionally cause disease.Several operons that mediate vancomycin resistance in Enterococcus spp. have been identified. Perhaps the most significant from an epidemiological standpoint is vanA-mediated vancomycin resistance, as these genes are carried on transposon Tn1546 (4) and confer inducible high-level resistance to vancomycin and teicoplanin (19). The chromosomally encoded phenotype mediated by the vanC gene is marked by low-level resistance to vancomycin (20) and is an intrinsic characteristic of E. gallinarum (11), E. casseliflavus, and E. flavescens (24).VRE that are resistant to high levels of vancomycin can be readily isolated from the feces of domestic animals in Europe (2, 10) and from humans with no exposure to hospitals (17, 31). There has been no report of high-level vancomycin resistance (Ͼ32 g/ml) in Enterococcus spp. from animal feces or from humans without hospital exposure in the United States. In spite of a 1997 call for the investigation of sources of VRE outside the health care setting in the United States (21), there are remarkably few publications containing such data (8). VRE that are intrinsically resistant to low levels of vancomycin, such as E. gallinarum, E. casseliflavus, and E. flavescens, have been isolated from bird feces (30), and E. gallinarum containing the vanC gene has been isolated from chickens and farm lagoons (8).As part of another study (18), our laboratory isolated thousands of fecal streptococci (a group that includes Enterococcus spp. and other group D Streptococcus spp.) from animal feces, wastewater, and surface waters. Some of these isolates were resistant to high levels (Ͼ32 g/ml) of vancomycin. In order to investigate the presence of VRE in wastewater, animal feces, and surface waters, all VRE were identified to the genus and species level.Isolation of vancomycin-resistant fecal streptococci. Fecal streptococcus isolates were obtained from the feces of cattle, chickens, dogs, pigs, and wild animals (birds and raccoons). Fecal streptococci were also isolated from wastewater samples collected at a central sewer lift station (designated LF)...
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