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Genetic analysis of multiple vancomycin-resistant Enterococcus isolates obtained serially from two long-term-care
D J Schoonmaker1, L H Bopp, A L Baltch
1Wadsworth Center, New York State Department of Health, Albany 12208, USA. djs03@health.state.ny.us
Journal of Clinical Microbiology
|July 3, 1998
Summary
Multiple vancomycin-resistant enterococci (VRE) isolates from two patients showed diverse genetic types. Some VRE isolates tested positive for vanA by PCR but negative by hybridization, highlighting the need for comprehensive isolate analysis.
Area of Science:
- Microbiology
- Infectious Diseases
- Molecular Biology
Background:
- Vancomycin-resistant enterococci (VRE) are a significant cause of hospital-acquired infections.
- Accurate detection of VRE and its resistance mechanisms is crucial for effective treatment and infection control.
Observation:
- Fifty-eight VRE isolates were collected from two patients over a nine-week period.
- Diverse pulsed-field gel electrophoresis (PFGE) patterns were observed within each patient's isolates.
- Polymerase chain reaction (PCR) detected the vanA gene in all isolates.
Findings:
- Despite PCR detection of vanA, hybridization assays revealed its absence in numerous isolates from patient B.
- This discrepancy suggests potential genetic heterogeneity or technical variations in resistance gene detection.
- Genetic diversity within VRE populations can complicate accurate resistance profiling.
Implications:
- The study underscores the importance of analyzing multiple isolates from high-risk patients to fully characterize VRE infections.
- Inconsistent results between PCR and hybridization for vanA detection warrant further investigation.
- Comprehensive microbiological analysis is essential for guiding patient management and preventing VRE transmission.