Antibiotic resistant fecal isolates of <i>Enterococci</i> among unselected patients outside the clinical sector: an epidemiological study from Southern Germany

Lietzau, Susanne; Hoewner, M.; Baum, Heike von; Marre, R.; Brenner, Hermann

doi:10.1002/pds.1167

Cited by 6 publications

(2 citation statements)

References 6 publications

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“…Blood culture strains were pre-selected by geography and hospital origin, year of isolation, and different van genotypes ( van-/A/B ). The blood culture isolates were compared against 68 human commensal (outpatient) isolates from four different prevalence studies performed in different parts of Germany (1996, 1997, 1999, 2003) [24,25] and 32 isolates from animal (chicken, pigs) and meat samples (broiler, pork) (1994, 1995, 1999) [21-23]. In all cases duplicate isolates were excluded based on clinical/epidemiological data (same patient/hospital or animal sample/flock) and of molecular typing results (for instance, based on Sma I-macrorestriction using PFGE for human commensal isolates [24,25]; unpublished results).…”

Section: Methodsmentioning

confidence: 99%

IS element IS16 as a molecular screening tool to identify hospital-associated strains of Enterococcus faecium

et al. 2011

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BackgroundHospital strains of Enterococcus faecium could be characterized and typed by various molecular methods (MLST, AFLP, MLVA) and allocated to a distinct clonal complex known as MLST CC17. However, these techniques are laborious, time-consuming and cost-intensive. Our aim was to identify hospital E. faecium strains and differentiate them from colonizing and animal variants by a simple, inexpensive and reliable PCR-based screening assay. We describe here performance and predictive value of a single PCR detecting the insertion element, IS16, to identify hospital E. faecium isolates within a collection of 260 strains of hospital, animal and human commensal origins.MethodsSpecific primers were selected amplifying a 547-bp fragment of IS16. Presence of IS16 was determined by PCR screenings among the 260 E. faecium isolates. Distribution of IS16 was compared with a prevalence of commonly used markers for hospital strains, esp and hylEfm. All isolates were typed by MLST and partly by PFGE. Location of IS16 was analysed by Southern hybridization of plasmid and chromosomal DNA.ResultsIS16 was exclusively distributed only among 155 invasive strains belonging to the clonal complex of hospital-associated strains ("CC17"; 28 MLST types) and various vancomycin resistance genotypes (vanA/B/negative). The five invasive IS16-negative strains did not belong to the clonal complex of hospital-associated strains (CC17). IS16 was absent in all but three isolates from 100 livestock, food-associated and human commensal strains ("non-CC17"; 64 MLST types). The three IS16-positive human commensal isolates revealed MLST types belonging to the clonal complex of hospital-associated strains (CC17). The values predicting a hospital-associated strain ("CC17") deduced from presence and absence of IS16 was 100% and thus superior to screening for the presence of esp (66%) and/or hylEfm (46%). Southern hybridizations revealed chromosomal as well as plasmid localization of IS16.ConclusionsThis simple screening assay for insertion element IS16 is capable of differentiating hospital-associated from human commensal, livestock- and food-associated E. faecium strains and thus allows predicting the epidemic strengths or supposed pathogenic potential of a given E. faecium isolate identified within the nosocomial setting.

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Section: Methodsmentioning

confidence: 99%

IS element IS16 as a molecular screening tool to identify hospital-associated strains of Enterococcus faecium

et al. 2011

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“…Mutations in the genes gyrA and parC were resolved for 98 of the 156 MLST-typed isolates. For the purpose of comparison, altogether 74 commensal E. faecium isolates originating from two independent prevalence studies among healthy persons from the community in two German federal states in 2002 and 2004 were included [38,39].…”

Section: Bacterial Strainsmentioning

confidence: 99%

High-level ciprofloxacin resistance among hospital-adapted Enterococcus faecium (CC17)

Werner

Fleige

Ewert

et al. 2010

International Journal of Antimicrobial Agents

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Hospital-adapted Enterococcus faecium differ from their colonising variants in humans and animals by additional genomic content. Molecular typing based on multilocus sequence typing (MLST) allows allocation of isolates to specific clonal complexes (CCs), such as CC17 for hospital-adapted strains. Acquired ampicillin resistance is a specific feature of these hospital isolates, especially in Europe. A few recent reports have described acquired high-level ciprofloxacin resistance as a supposed feature of hospital-adapted E. faecium strains. In the present retrospective analysis, ciprofloxacin minimum inhibitory concentrations (MICs) of 609 clinical isolates from German hospital patients (1997-2007) were determined and a breakpoint for high-level resistance was deduced (>16mg/L). Acquired high-level ciprofloxacin resistance was distributed among isolates of 26 different MLST types (all CC17), indicating a wide prevalence of this acquired resistance trait among the hospital-adapted E. faecium population. High-level ciprofloxacin resistance was linked to gyrA and parC mutations in 98 investigated isolates. Eleven different allele types or combinations thereof were identified. Their allocation to specific MLST and pulsed-field gel electrophoresis (PFGE) types revealed differences in the emergence and spread of corresponding mutations and strains.

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Current awareness: Pharmacoepidemiology and drug safety

2006

Pharmacoepidemiology and Drug

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of pharmacoepidemiology and drug safety. Each bibliography is divided into 20 sections: 1 Books, Reviews & Symposia; 2 General; 3 Anti‐infective Agents; 4 Cardiovascular System Agents; 5 CNS Depressive Agents; 6 Non‐steroidal Anti‐inflammatory Agents; 7 CNS Agents; 8 Anti‐neoplastic Agents; 9 Haematological Agents; 10 Neuroregulator‐Blocking Agents; 11 Dermatological Agents; 12 Immunosuppressive Agents; 13 Autonomic Agents; 14 Respiratory System Agents; 15 Neuromuscular Agents; 16 Reproductive System Agents; 17 Gastrointestinal System Agents; 18 Anti‐inflammatory Agents ‐ Steroidal; 19 Teratogens/fetal exposure; 20 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted.

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Antibiotic resistant fecal isolates of Enterococci among unselected patients outside the clinical sector: an epidemiological study from Southern Germany

Abstract: Prevalences of resistance were generally lower than and patterns of resistance were quite different from previous investigations in the clinical setting. Recent antibiotic use was associated with increased colonization with resistant strains.

Cited by 6 publications

References 6 publications

IS element IS16 as a molecular screening tool to identify hospital-associated strains of Enterococcus faecium

IS element IS16 as a molecular screening tool to identify hospital-associated strains of Enterococcus faecium

High-level ciprofloxacin resistance among hospital-adapted Enterococcus faecium (CC17)

Current awareness: Pharmacoepidemiology and drug safety

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