Thirteen vancomycin-resistant and teicoplanin-susceptible Enterococcus faecalis isolates were recovered from unrelated patients in three Spanish hospitals from November 2009 to December 2010. All isolates carried the vanB2 gene, showed indistinguishable or closely-related PFGE patterns and were ascribed to the sequence type ST6 (included into the high-risk clonal-complex CC2). They showed a multiresistance phenotype (erythromycin, tetracycline, ciprofloxacin and high-level-resistance to streptomycin, gentamicin and kanamycin) and harboured the aac(6')-aph(2"), ant(6)-Ia, and tet(M)+/-tet(L) genes. All isolates produced gelatinase and harboured the gelE gene, but not the esp or hyl genes. The inclusion of the vanB2 gene into the Tn5382 transposon was demonstrated in one isolate. Clonal dissemination of vanB2-containing the E. faecalis strain is demonstrated.

The incidence of anaerobic bacteria in bile, and the relationship between bacterial species isolated from the bile and the clinical characteristics of disease in these patients was studied. One hundred and twenty-five bile specimens obtained during surgery from the same number of patients were cultured aerobically and anaerobically. Seventy patients (56%) had positive cultures and in 30% of the patients with positive cultures anaerobic bacteria were recovered, usually together with aerobic bacteria. Members of the Bacteroides fragilis group were the most frequently isolated anaerobic organisms. There was a high rate of isolation of anaerobic bacteria from bile in patients with gangrenous cholecystitis (72%) or acute cholangitis (50%). Administration of antibiotics effective against anaerobic bacteria should be considered when treating these diseases.

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