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Related Experiment Videos

Epidemic and nonepidemic multidrug-resistant Enterococcus faecium.

Helen L Leavis1, Rob J L Willems, Janetta Top

  • 1University Medical Center Utrecht, Utrecht, the Netherlands.

Emerging Infectious Diseases
|October 2, 2003
PubMed
Summary
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Vancomycin-resistant Enterococcus faecium (VREF) strains in hospitals are genetically related to susceptible strains. Nosocomial selection favors specific E. faecium subtypes that acquire vancomycin resistance.

Area of Science:

  • Microbiology
  • Epidemiology
  • Genetics

Background:

  • Vancomycin-resistant Enterococcus faecium (VREF) epidemiology differs between Europe (community reservoir) and the US (nosocomial).
  • Previous studies identified host-specific genogroups and genetic lineages of VREF linked to hospital outbreaks, characterized by the esp gene and purK1 allele.

Purpose of the Study:

  • To investigate the genetic relatedness of vanA VREF and vancomycin-susceptible E. faecium (VSEF) from diverse sources.
  • To identify genetic markers associated with VREF and VSEF isolates from different epidemiological settings.

Main Methods:

  • Genotyping of 108 vanA VREF and 92 VSEF isolates.
  • Susceptibility testing for ampicillin.
  • Sequencing of the purK housekeeping gene (purK1).

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  • Testing for the presence of the esp gene.

    • Main Results:

    • VSEF clusters aligned with known VREF genogroups.
    • Strong associations found between VSEF and VREF isolates exhibiting ampicillin resistance, esp presence, and purK1.
    • Genotypes with esp, purK1, and ampicillin resistance were prevalent in outbreak isolates, rare in community isolates.
    • Vancomycin resistance was not specifically linked to genogroups.

    Conclusions:

    • VREF and VSEF from various sources are genetically related.
    • Evidence suggests nosocomial selection of specific E. faecium subtypes that acquire vancomycin resistance via horizontal gene transfer.