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Molecular characterization of vancomycin-resistant Enterococcus faecium isolates from Bermuda.

Patrick Eberechi Akpaka1, Shivnarine Kissoon1, Clyde Wilson2

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Molecular characterization of vancomycin-resistant enterococci (VRE) in Bermuda revealed all eighteen isolates were vanA-positive E. faecium. Most isolates belonged to clonal complex 17 (CC17), a common cause of hospital outbreaks.

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Area of Science:

  • Microbiology
  • Infectious Diseases
  • Molecular Epidemiology

Background:

  • Vancomycin-resistant enterococci (VRE) pose a significant threat to public health globally.
  • The molecular epidemiology of VRE on Bermuda Island was previously uncharacterized.
  • Understanding VRE characteristics is crucial for effective infection control.

Purpose of the Study:

  • To investigate the phenotypic and genotypic features of VRE isolates from Bermuda Island.
  • To determine the genetic relatedness and antimicrobial resistance profiles of VRE.
  • To identify potential sources and transmission patterns of VRE in the local healthcare setting.

Main Methods:

  • Phenotypic analysis using chromogenic agar and E-tests for antimicrobial susceptibility.
  • Genotypic characterization including polymerase chain reaction (PCR) for specific genes (vanA, esp).
  • Molecular typing techniques such as pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) were employed.

Main Results:

  • Eighteen *Enterococcus faecium* isolates were analyzed, all exhibiting vancomycin resistance.
  • All isolates were susceptible to linezolid and quinupristin/dalfopristin.
  • The *vanA* and *esp* genes were detected in all isolates.
  • MLST analysis identified sequence types predominantly linked to clonal complex 17 (CC17).

Conclusions:

  • Bermuda Island VRE isolates are primarily *E. faecium* harboring the *vanA* gene.
  • The prevalence of CC17 suggests a potential for hospital-acquired VRE outbreaks.
  • Continued infection control, antibiotic stewardship, and surveillance are essential for managing VRE on the island.