Clonal dissemination of vancomycin-resistant Enterococcus faecium ST412 in a Brazilian region

Abstract

Vancomycin-resistant Enterococcus faecium (VREfm) has emerged as an important global nosocomial pathogen, and this trend is associated with the spread of high-risk clones. Here, we determined the genetic and phenotypic features of 93 VREfm isolates that were obtained from patients in 13 hospitals in Vitória, Espírito Santo, Brazil, during 2012-2013. All the isolates were vancomycin-resistant and harbored the vanA gene. Only 6 (6.5%) of the VREfm isolates showed the ability to form biofilm. The 93 isolates analyzed belong to a single pulsed-field gel electrophoresis lineage and presented six subtypes. MLST genotyping showed that all VREfm belonged to ST412 (the high-risk clone, hospital-adapted). The present study describes the dissemination of ST412 clone in the local hospitals. The clonal spread of these ST412 isolates in the area we analyzed as well as other hospitals in southeastern Brazil supports the importance of identifying and controlling the presence of these microorganisms in health care-related services.

Genomic Epidemiology of Vancomycin-Resistant Enterococcus faecium (VREfm) in Latin America: Revisiting The Global VRE Population Structure

“…Interestingly, some South American countries such as Brazil (no isolates available for this study) have reported VREfm since 1997 37 , and their prevalence appears to be increasing, exhibiting a shift from E. faecalis to VREfm since 2007 15 . Of interest, ST412 isolates reported in some regions of Brazil 38,39 have also been detected in Caribbean countries 40 and this sequence type was also identified in our collection in Colombia, Peru and Venezuela since 2005 14 , suggesting wide dissemination of this genetic lineage in the region.…”

Genomic epidemiology of vancomycin resistantEnterococcus faecium(VREfm) in Latin America: Revisiting the global VRE population structure

“…Interestingly, some South American countries such as Brazil (no isolates available for this study) have reported VR Efm since 1997 37 , and their prevalence appears to be increasing exhibiting a shift from E. faecalis to VR Efm since 2007 15 . Of interest, ST412 isolates reported in some regions of Brazil 38,39 have also been detected in some Caribbean countries 40 and this sequence type was also identified in our collection in Colombia, Peru and Venezuela since 2005 14 , suggesting wide dissemination of this genetic lineage.…”

High diversity of vancomycin-resistant Enterococcus faecium isolated in Southern Brazil

“…Around the world, studies have reported the spread of CC-17 (Alves et al, 2017;Brilliantova et al, 2010;López et al, 2012;Palazzo et al, 2011), a lineage that exhibits resistance to most antibiotics clinically used for the treatment of enterococcal infections. It is well adapted to the hospital environment and has been associated with most of the reported hospital outbreaks worldwide (Panesso et al, 2010;Willems et al, 2005).…”

“…The ability of Enterococcus faecium to rapidly acquire mobile genetic elements associated to antimicrobial resistance is well-established (Gilmore et al, 2013;Cattoir and Giard, 2014;García-Solache et al, 2016). Vancomycin-resistant Enterococcus faecium (VREfm) has become increasingly common in some hospital settings and their clonal spread has been described worldwide (Freitas et al, 2016;Mahony et al, 2018), including Brazil (Alves et al, 2017;Resende et al, 2014;Sacramento et al, 2017). Most VREfm isolated from Brazilian hospitals belong to clonal complex 17 (CC-17), i.e.…”

“…Most VREfm isolated from Brazilian hospitals belong to clonal complex 17 (CC-17), i.e. a well-adapted lineage to the hospital environment and responsible for the majority of VREfm infections worldwide (Top et al, 2008;Palazzo et al, 2011;Alves et al, 2017;Sacramento et al, 2017). VanA-related VREfm is the most prevalent phenotype around the world and frequently presents virulence factors which facilitates the infection process and multiresistance features that considerably reduce the therapeutic options (Ahmed and Baptiste, 2017).…”