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Isolation and Identification of Waterborne Antibiotic-Resistant Bacteria and Molecular Characterization of their Antibiotic Resistance Genes

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Published on: March 3, 2023

Occult Vancomycin-Resistant Enterococcus faecium ST117 Displaying a Highly Mutated vanB₂ Operon.

Antonella Santona¹, Elisa Taviani², Maura Fiamma³

¹Department of Biomedical Science, University of Sassari, Viale San Pietro 43/b, 07100 Sassari, Italy.

Antibiotics (Basel, Switzerland)

|March 29, 2023

Summary

This study identified vancomycin-resistant Enterococcus faecium (VREfm) in Sardinia, Italy. Genotypic vanB gene detection was crucial as Vitek2 testing sometimes failed, highlighting the need for improved diagnostics to prevent VREfm spread.

Keywords:

Vitek2 system WGS cgMLST occult vanB2-VREfm

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Published on: January 5, 2024

Area of Science:

Medical Microbiology
Infectious Diseases
Antimicrobial Resistance

Background:

Limited data exists on clinical Enterococcus faecium infections in Sardinia, Italy.
Enterococcus faecium is a significant nosocomial pathogen, often developing vancomycin resistance.

Purpose of the Study:

To investigate the antimicrobial susceptibility and genotypic characteristics of Enterococcus faecium isolates from Sassari, Italy.
To evaluate the performance of Vitek2 system in detecting vancomycin resistance in Enterococcus faecium.

Main Methods:

Antimicrobial susceptibility testing using Vitek2 system.
Genotypic analysis including PCR, MLST, and Whole Genome Sequencing (WGS).
Phenotypic confirmation of vancomycin resistance.

Main Results:

Two vanB-type vancomycin-resistant Enterococcus faecium (VREfm) isolates were identified.
Vitek2 system failed to detect vancomycin resistance in one vanB-positive isolate.
All identified isolates possessed mutated vanB2 operons within a Tn1549 transposon.
Molecular typing revealed a polyclonal population, with ST117 being common among VREfm and vancomycin-susceptible E. faecium (VSEfm).

Conclusions:

The Vitek2 system may not reliably detect all vanB-carrying VREfm isolates.
Mutations in the vanB2 operon contribute to vancomycin resistance.
Alternative diagnostic methods are essential for accurate VREfm detection to prevent treatment failure and transmission.