Clonal Spread of a Vancomycin-Resistant
            <i>Enterococcus faecium</i>
            Strain among Bloodstream-Infecting Isolates in Italy

Stampone, Lucia; Grosso, María Del; Boccia, Delia; Pantosti, Annalisa

doi:10.1128/jcm.43.4.1575-1580.2005

Cited by 51 publications

(38 citation statements)

References 32 publications

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“…CC17 is the only recognized E. faecium HiRCC, nowadays globally disseminated, which has been sporadically isolated from nonhospitalized humans (3,(8)(9)(10). Different studies have analyzed the population structure of local enterococci, but they are focused mainly on clinical strains with a specific phenotype, such as vancomycin resistance, generally isolated in a short temporal frame (2,7,16,18,27,29,36).…”

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confidence: 99%

Dispersion of Multidrug-Resistant Enterococcus faecium Isolates Belonging to Major Clonal Complexes in Different Portuguese Settings

Freitas

Novais

Ruíz-Garbajosa

et al. 2009

Appl Environ Microbiol

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The population structure of 56 Enterococcus faecium isolates selected from a collection of enterococci from humans, animals, and the environment in Portugal (1997 to 2007) was analyzed by multilocus sequence typing. We identified 41 sequence types clustering into CC17, CC5, CC9, CC22 and CC94, all clonal lineages comprising isolates from different hosts. Our findings highlight the role of community-associated hosts as reservoirs of enterococci able to cause human infections.

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confidence: 99%

Dispersion of Multidrug-Resistant Enterococcus faecium Isolates Belonging to Major Clonal Complexes in Different Portuguese Settings

Freitas

Novais

Ruíz-Garbajosa

et al. 2009

Appl Environ Microbiol

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“…MLST confirmed the unrelatedness of human and nonhuman VRE, as had been established by PFGE beforehand, and confirmed subgroup C1 as responsible for human cases (1). Several authors used MLST for outbreak investigations thereafter (17,24,29). The clonal complex of sequence type 17 (ST-17) was repeatedly shown to be related to the VRE problem worldwide.…”

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confidence: 97%

Molecular Epidemiology of Hospital-Acquired Vancomycin-Resistant Enterococci

et al. 2006

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Vancomycin-resistant Enterococcus faecium strains are a significant cause of nosocomial infections in predisposed patients. Multiple-locus variable-number tandem repeat analysis (MLVA) has been validated recently by use of a global strain collection. In this report, we applied MLVA together with multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) to type 14 isolates from three clusters of patients colonized or infected with vancomycin-resistant Enterococcus faecium and another 10 epidemiologically unrelated isolates from the same hospital. The clusters could be distinguished by all three typing methods, which proved to be concordant. PFGE patterns provided the highest resolution. We observed seven sequence types (ST), six MLVA types (MT), and nine distinct ST/MT combinations. The combination of MLST and MLVA may be an alternative to PFGE in hospital epidemiology, providing the benefits of high accuracy, reproducibility, and portability.

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“…MLST was originally employed to identify hypervirulent lineages of Neisseria meningitides (171). However, the approach has now been applied to a variety of other pathogens, including S. aureus (72,79,83,92,117,206) and enterococci (259,284), for the assignment of S. pneumoniae strains to major hypervirulent, penicillin-resistant, and multiple-antibioticresistant clones (84,232), and to a large number of other organisms (73,85,160,212,217,221). In evaluating MLST it is important to remember that, like multilocus enzyme electrophoresis, the method was originally designed to assess genetic interrelationships in bacterial populations with sufficient opportunity for the sequence of housekeeping genes to diversify, such as in evolutionary studies.…”

Section: Mlstmentioning

confidence: 99%

Application of Molecular Techniques to the Study of Hospital Infection

et al. 2006

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SUMMARY Nosocomial infections are an important source of morbidity and mortality in hospital settings, afflicting an estimated 2 million patients in United States each year. This number represents up to 5% of hospitalized patients and results in an estimated 88,000 deaths and 4.5 billion dollars in excess health care costs. Increasingly, hospital-acquired infections with multidrug-resistant pathogens represent a major problem in patients. Understanding pathogen relatedness is essential for determining the epidemiology of nosocomial infections and aiding in the design of rational pathogen control methods. The role of pathogen typing is to determine whether epidemiologically related isolates are also genetically related. To determine molecular relatedness of isolates for epidemiologic investigation, new technologies based on DNA, or molecular analysis, are methods of choice. These DNA-based molecular methodologies include pulsed-field gel electrophoresis (PFGE), PCR-based typing methods, and multilocus sequence analysis. Establishing clonality of pathogens can aid in the identification of the source (environmental or personnel) of organisms, distinguish infectious from noninfectious strains, and distinguish relapse from reinfection. The integration of molecular typing with conventional hospital epidemiologic surveillance has been proven to be cost-effective due to the associated reduction in the number of nosocomial infections. Cost-effectiveness is maximized through the collaboration of the laboratory, through epidemiologic typing, and the infection control department during epidemiologic investigations.

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Clonal Spread of a Vancomycin-Resistant Enterococcus faecium Strain among Bloodstream-Infecting Isolates in Italy

Abstract: Recent data indicated that the rate of vancomycin resistance in bloodstream-infecting enterococcal isolates in Italy is

Cited by 51 publications

References 32 publications

Dispersion of Multidrug-Resistant Enterococcus faecium Isolates Belonging to Major Clonal Complexes in Different Portuguese Settings

Dispersion of Multidrug-Resistant Enterococcus faecium Isolates Belonging to Major Clonal Complexes in Different Portuguese Settings

Molecular Epidemiology of Hospital-Acquired Vancomycin-Resistant Enterococci

Application of Molecular Techniques to the Study of Hospital Infection

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