Molecular Epidemiology of Hospital-Acquired Vancomycin-Resistant Enterococci

Abstract

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.

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

“…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).…”

Characterization of Vancomycin-Resistant Enterococcus faecium Isolated from Swine in Three Michigan Counties

“…It has been suggested that the CC5 lineage of E. faecium may have a fitness advantage in swine and could spread more readily than other, less adapted strains between swine and potentially between swine and humans (47). Many studies have shown that it is possible for the same strains of enterococci to infect both humans and farm animals (3,6,13,23,33,53,56). If large numbers of CC5 strains acquire vancomycin resistance, this could pose a health threat to humans since this also suggests the potential for the occurrence of vancomycin-resistant enterococci in food.…”

“…This has been attributed to less use of vancomycin and extended-spectrum cephalosporins in European hospitals (35). Recently, there have been reports of increasing numbers of infections with VRE in hospitalized patients in European countries (3,21,34,37,46,64). A specific clonal complex of E. faecium strains, clonal complex 17 (CC17), has been responsible for outbreaks in hospitals worldwide, including the United States (7,38,39,45,64).…”

“…Although E. faecium strains in CC17 are associated with epidemicity in hospitals, there has been a report of a CC17 strain in swine from Portugal (20). Conversely, several studies in Europe have reported finding swine-adapted E. faecium CC5 strains in humans (3,11,12,20,23,30,33).…”

Comparison of genetic epidemiology of vancomycin-resistant Enterococcus faecium isolates from humans and poultry

“…The incidence of VRE ranges from 20 to 40 % in the USA and is .10 % in some European countries (Abele-Horn et al, 2006). Since the use of the glycopeptide antibiotic avoparcin (a vancomycin analogue) as a growth promoter in animals, VRE has also been demonstrated in the faeces of avoparcin-exposed farm animals and animal-derived food products such as raw meat.…”