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Published on: March 24, 2023
Molecular epidemiology of Enterococcus faecalis in liver transplant patients at University Hospital Groningen
K Waar1, R J L Willems, M J H Slooff
1Department of Medical Microbiology, University of Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB Groningen, The Netherlands. k.waar@med.rug.nl
Abstract:
We report the molecular epidemiology of Enterococcus faecalis in liver transplant patients transplanted at the University Hospital Groningen (The Netherlands) as determined by amplified fragment length polymorphism (AFLP) typing. A total of 133 E. faecalis isolates were cultured from the faeces and throat (95 isolates) or clinical sites (35 isolates) of 43 liver transplant patients. Among these 133 isolates, 15 different AFLP types could be identified with 90% AFLP similarity. Of these 15 groups, nine contained isolates from more than one patient, which may indicate transmission of E. faecalis isolates between patients. In five of these groups transmission could be explained by the fact that patients carrying identical strains were staying in the same ward at the same time. One of these epidemic isolates (AFLP type K) distinguished itself by colonizing 23 liver transplant patients during 15 months. Antimicrobial susceptibility testing did not reveal any multi-resistant isolates. This study showed that transmission of susceptible E. faecalis isolates occurs frequently on the liver transplant wards. Detection of this transmission and understanding of the mechanism is important, as it might also be an indicator of possible transmission of enterococci resistant to antibiotics.
Insights
Molecular epidemiology revealed frequent transmission of susceptible Enterococcus faecalis strains among liver transplant patients. Understanding this transmission is crucial for preventing the spread of antibiotic-resistant enterococci.
Area of Science:
- Microbiology
- Infectious Diseases
- Transplant Surgery
Background:
- Enterococcus faecalis is a common cause of infections, particularly in immunocompromised patients.
- Liver transplant recipients are at high risk for healthcare-associated infections.
- Understanding the transmission dynamics of E. faecalis in this population is critical for infection control.
Purpose of the Study:
- To investigate the molecular epidemiology of Enterococcus faecalis in liver transplant patients.
- To identify potential transmission events of E. faecalis between patients.
- To assess the implications for infection control in liver transplant wards.
Main Methods:
- Amplified fragment length polymorphism (AFLP) typing was used to analyze E. faecalis isolates.
- Isolates were collected from fecal, throat, and clinical sites of liver transplant patients.
- Antimicrobial susceptibility testing was performed on identified isolates.
Main Results:
- 133 E. faecalis isolates from 43 patients yielded 15 distinct AFLP types.
- Nine AFLP types were found in multiple patients, suggesting inter-patient transmission.
- One prevalent strain (AFLP type K) colonized 23 patients over 15 months.
- No multi-resistant isolates were detected, but susceptible E. faecalis transmission was frequent.
Conclusions:
- Susceptible Enterococcus faecalis strains are frequently transmitted among liver transplant patients.
- Ward proximity was linked to transmission events for some strains.
- Monitoring susceptible E. faecalis transmission can serve as an indicator for potential antibiotic-resistant enterococci spread.
