High Genetic Diversity ofEnterococcus faeciumandEnterococcus faecalisClinical Isolates by Pulsed-Field Gel Electrophoresis and Multilocus Sequence Typing from a Hospital in Malaysia

Abstract

Little is known on the genetic relatedness and potential dissemination of particular enterococcal clones in Malaysia. We studied the antibiotic susceptibility profiles of Enterococcus faecium and Enterococcus faecalis and subjected them to pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). E. faecium and E. faecalis displayed 27 and 30 pulsotypes, respectively, and 10 representative E. faecium and E. faecalis isolates (five each) yielded few different sequence types (STs): ST17 (2 isolates), ST78, ST203, and ST601 for E. faecium, and ST6, ST16, ST28, ST179, and ST399 for E. faecalis. Resistance to tazobactam-piperacillin and ampicillin amongst E. faecium isolates was highly observed as compared to E. faecalis isolates. All of the isolates were sensitive to vancomycin and teicoplanin. The presence of epidemic and nosocomial strains of selected E. faecium STs: 17, 78, and 203 and E. faecalis ST6 as well as high rates of resistance to multiple antibiotics amongst E. faecium isolates is of a particular concern.

The interactions between esp, fsr, gelE genes and biofilm formation and pfge analysis of clinical Enterococcus faecium strains

“…Out of these two isolates, all the other isolates were included in a major cluster A at 43% similarity level and subdivided into six subgroups (Figure 2). Our PFGE results are similar from the point of low level homology among clinical E. faecium isolates with the study conducted by Weng et al (2013). In another study performed previously by Bedendo and Pignatari (2000) were investigated genetic diversity among 20 clinical E. faecium isolates by using REP-PCR and PFGE, so PFGE had revealed easier interpreted band patterns in comparison with REP-PCR.…”

Public Health Risks of Multiple-Drug-Resistant Enterococcus spp. in Southeast Asia

“…Generally, the antibiotic of choice for the treatment of enterococcal infections in humans is ampicillin, and vancomycin is an alternative agent (66). Prudent antibiotic use is an essential component for control of the spread of VRE.…”

“…There was also an increase in the number of patients with ciprofloxacin-resistant E. faecalis from 248 (20.6%) in 2012 to 437 (21.1%) in 2013 and in the number of patients with penicillin-resistant E. faecium from 309 (84.4%) in 2012 to 415 (89.6%) in 2013 (70). A study in Malaysia isolated tazobactampiperacillin-, ampicillin-, and penicillin-resistant and high-level gentamicin-resistant enterococcal strains from hospitalized patients (66). Another case study in 2008 discovered vancomycin-, teicoplanin-, ampicillin-, and gentamicin-resistant E. faecium strains in two patients with chronic diabetes mellitus and urinary tract infection undergoing a 3-to 12-day course of treatment with cloxacillin, ceftriaxone, erythromycin, and vancomycin (71).…”

Molecular Appraisement of Isolated Antibiotic Resistant Enterococci from Vaginal Specimen in Spontaneously Abortion Women’s

“…Sometimes the disseminated clone has important characteristic such as virulent gene or high resistance, so that preventing of such strains from spread is very important. Studies on one prevalent epidemic clone in the burn unit of a hospital in Taiwan showed that this epidemic clone remained longer in patient's body than non-clonal strains and cause various and severe infections [36]. Since the strains with identical genotypes from aspect of virulent genes represented different types of PFGE or the strains with different genotype showed similar patterns, it could be identified that there is no association between virulent genotypes and PFGE patterns.…”