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High Phenotypic and Genotypic Diversity of Enterococcus faecium from Clinical and Commensal Isolates in Third Level

Claudia Mayoral-Terán1, Karen Flores-Moreno1, Miguel A Cevallos2

  • 1Programa de Inmunología Molecular Microbiana, Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México-Ciudad Universitaria, Mexico City, Mexico.

Microbial Drug Resistance (Larchmont, N.Y.)
|September 24, 2019
PubMed

Insights

A study on vancomycin-resistant Enterococcus faecium (VREfm) in a Mexican hospital found high diversity among clinical, environmental, and commensal strains. Most clinical VREfm isolates belonged to a specific clonal complex, distinct from environmental and commensal strains.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Genetics

Background:

  • Multiresistant microorganisms, such as vancomycin-resistant Enterococcus faecium (VREfm), are emerging nosocomial pathogens.
  • Antimicrobial use and chemotherapy regimens contribute to the rise of these resistant strains.
  • VREfm outbreaks pose significant challenges in healthcare settings, particularly in hemato-oncology wards.

Purpose of the Study:

  • To investigate the clonal complex (CC) of VREfm strains involved in a bloodstream infection outbreak.
  • To compare the genetic relatedness of outbreak VREfm strains with commensal and environmental isolates.
  • To understand the diversity and population structure of VREfm in a specific hospital setting.

Main Methods:

  • Analysis of sixty VREfm clinical, environmental, and commensal strains.
  • Construction of a cladogram using Vitek data.
  • Phylogenetic tree construction utilizing Multilocus Sequence Typing (MLST) data.

Main Results:

  • Twenty new sequence types (STs) were identified.
  • A significant proportion (17/43) of clinical isolates belonged to clonal complex 17 (CC17).
  • Clinical isolates showed distinct genetic profiles compared to most environmental and commensal isolates, with some exceptions.

Conclusions:

  • A high degree of diversity exists among clinical, environmental, and commensal VREfm strains within a single hospital.
  • The predominant clinical VREfm strains in the outbreak were genetically distinct from commensal and environmental strains.
  • Understanding VREfm population dynamics is crucial for controlling hospital-acquired infections.
Keywords:
Enterococcus faeciumMLSTbacteremiabiotypesclinical isolatescommensal isolatesenvironmental strainshigh diversitypolyclonal outbreakvancomycin resistance

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