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Comparison of high-level gentamicin-resistant Enterococcus faecium isolates from different continents
N Woodford1, D Morrison, B Cookson
1Antibiotic Laboratory, Central Public Health Laboratory, London, England.
Antimicrobial Agents and Chemotherapy
|April 1, 1993
Summary
Widespread dissemination of a gentamicin resistance (Gmr) plasmid, not a specific clone, is suggested among high-level gentamicin-resistant (HLGR) Enterococcus faecium isolates globally. This indicates a common source for the resistance gene
Area of Science:
- Clinical microbiology
- Molecular epidemiology
- Antimicrobial resistance
Background:
- High-level gentamicin resistance (HLGR) in Enterococcus faecium poses a significant clinical challenge.
- Understanding the mechanisms and spread of gentamicin resistance (Gmr) is crucial for infection control.
Purpose of the Study:
- To investigate the molecular epidemiology of HLGR Enterococcus faecium isolates from multiple continents.
- To determine if clonal spread of a specific HLGR E. faecium strain or dissemination of a Gmr plasmid is responsible for resistance.
Main Methods:
- Analysis of eight clinical E. faecium isolates exhibiting high-level gentamicin resistance.
- Utilized ribotyping, plasmid profiling, and extended antimicrobial susceptibility testing.
- Restriction endonuclease digestion and cross-hybridization studies of Gmr plasmids.
Main Results:
- Isolates were generally distinct, refuting clonal dissemination of a single E. faecium strain.
- All isolates harbored closely related Gmr plasmids, suggesting widespread plasmid dissemination.
- The gentamicin resistance gene identified differed from previously characterized transposons.
Conclusions:
- The study strongly suggests the widespread dissemination of a single Gmr plasmid and its variants among HLGR E. faecium.
- This contrasts with clonal spread, highlighting the role of plasmids in the global spread of antibiotic resistance.