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Molecular analysis of vancomycin-resistant Enterococcus faecalis from Michigan hospitals during a 10 year period
Preeti N Malani1, LeeAnn Thal, Susan M Donabedian
1Department of Internal Medicine, Division of Infectious Disease, Veterans Affairs Healthcare Center and University of Michigan Medical School, Ann Arbor, USA.
Abstract:
We evaluated the molecular relatedness of 47 clinical isolates of vancomycin-resistant Enterococcus faecalis collected from 15 Michigan hospitals from 1991 to 2000. There were 17 PFGE strain types for the 47 isolates. Ten of 15 hospitals demonstrated interhospital, and three of 15 intrahospital, dissemination of some isolates. Forty-two isolates (89.4%) demonstrated vanB resistance. All vanA isolates comprised unique PFGE groups, suggesting transposon dissemination or the presence of a similar plasmid. The results of this study suggest inter- and intrahospital dissemination of strains of vancomycin-resistant E. faecalis during a 10 year period in Michigan.
Insights
Vancomycin-resistant Enterococcus faecalis (VRE) strains spread between and within Michigan hospitals from 1991-2000. Most VRE isolates showed vanB resistance, indicating significant dissemination challenges.
Area of Science:
- Microbiology
- Infectious Diseases
- Molecular Epidemiology
Background:
- Vancomycin-resistant Enterococcus faecalis (VRE) is a significant healthcare-associated pathogen.
- Understanding VRE transmission dynamics is crucial for infection control.
Purpose of the Study:
- To investigate the molecular relatedness and dissemination patterns of VRE faecalis clinical isolates in Michigan hospitals.
- To characterize the resistance mechanisms present in these isolates.
Main Methods:
- Pulsed-field gel electrophoresis (PFGE) was used to determine strain types of 47 VRE faecalis isolates.
- Isolates were collected from 15 Michigan hospitals between 1991 and 2000.
- Vancomycin resistance genes (vanA and vanB) were analyzed.
Main Results:
- Seventeen distinct PFGE strain types were identified among the 47 isolates.
- Interhospital dissemination was observed in 10 of 15 hospitals, and intrahospital dissemination in 3 of 15.
- Eighty-nine percent (42/47) of isolates harbored the vanB resistance gene.
Conclusions:
- VRE faecalis strains exhibited significant molecular diversity and dissemination capabilities across Michigan healthcare settings.
- The prevalence of the vanB gene suggests specific resistance mechanisms were driving VRE spread.
- Findings highlight the need for robust infection control strategies to mitigate VRE transmission.