Assessment of high-level gentamicin and glycopeptide-resistant Enterococcus faecalis and E. faecium clonal structure in a Portuguese hospital over a 3-year period

Abstract

This study focussed on the clonal structure and temporal distribution of E. faecalis and E. faecium with high-level resistance to gentamicin (HLGR) and glycopeptides (GR) collected from clinical samples during 2004 to 2006 at a Portuguese Hospital. The findings were an E. faecalis-dominant and epidemic clone (PFGE-AO), the maintenance of a major epidemic E. faecium clone (PFGE-c) and a high prevalence of putative virulence genes--asa1 (aggregation substances), gelE (gelatinase), cylA (cytolysin), esp (enterococcal surface protein), and hyl (hyaluronidase)--most of them significantly associated with the major clones of both species. The E. faecalis GR isolates ST6 and the E. faecium GR isolates ST17, ST18 and ST280 belong to the clonal complexes E. faecalis-CC2 and E. faecium-CC17, which are well adapted to the nosocomial setting and are disseminated worldwide. This study highlights the need for continuous and active surveillance in this Portuguese hospital in order to follow the evolution of these epidemic and persistent clones.

Microevolutionary Events Involving Narrow Host Plasmids Influences Local Fixation of Vancomycin-Resistance in Enterococcus Populations

“…Recent retrospective analysis of enterococcal populations suggests that the temporal evolution of the population biology of Enterococci is driven by a succession of epidemic waves of enterococcal human specific lineages, Efm ST78 and Efs ST6 emerging in the last decade at global scale similarly to that reported for other pathogens [19], [23], [24]. In Portugal, the population structure of VRE analysed in this study comprises isolates of main human Efm lineages, ST18 (ST18, ST132) being much more abundant than ST17 (represented by a single isolate of early ST16 lineage) [31], or ST78 (represented by sporadic ST80 and ST656, the first one linked to early VRE outbreaks) [25], [29]. It is worthwhile highlighting the recent detection of isolates of another Efm lineage in hospitals of the Oporto area (http://www.mlst.net) as ST117 Efm (ST78 lineage), which would reflect the increasing trend of isolates belonging to the ST78 lineage at international level.…”

EC300: a phage-based, bacteriolysin-like protein with enhanced antibacterial activity against Enterococcus faecalis

“…The image shows the lysis halos developed after overnight incubation at 37°C. Lysis halos from individually spotted mEC300 (0.31 nmol), EC300 (0.31 nmol), and CWB170 (1.86 nmol) are shown in the bottom row described as highly prevalent in nosocomial settings and disseminated worldwide (Kuch et al 2012;Mato et al 2009;Top et al 2008). Four quantities of EC300 (10, 3.3, 1.1, and 0.37 μg) were spotted on soft-agar TSA lawns that had been inoculated with cells from exponentially growing cultures of each strain of the panel (see methods).…”

“…When necessary, LB was supplemented with ampicillin (100 μg/ml), kanamycin (30 μg/ml), and/or tetracycline (10 μg/ml). The antibacterial activity of EC300 was tested against a panel of typed, multiresistant enterococcal clinical strains (Table 1), which was composed of 28 E. faecalis and 21 E. faecium isolates from patients of a Portuguese hospital between 2004 and 2006 (Mato et al 2009), plus the two model E. faecalis clinical strains MMH594 (NR-31975, BEI Resources, Manassas, USA) and V583 (ATCC 700802, ATCC/LGC Standards, Teddington, UK) (Huycke et al 1991;Paulsen et al 2003;Sahm et al 1989;Shankar et al 2002). These strains and the E. faecalis clinical isolates 1518/05 and 926/ 05 from Technophage collection (Lisbon, Portugal) were grown in Tryptic Soy Broth (TSB) at 37°C.…”

Detection of <i>van</i>A-Containing <i>Enterococcus</i> Species in Faecal Microbiota of Gilthead Seabream (<i>Sparus aurata</i>)

“…In conclusion, marine fish can carry van A-containing enterococci of diverse species and it is interesting that E. faecium and E. faecalis strains ascribed to HRCC, (CC17 and CC2, respectively), usually associated with the hospital setting (11, 14, 22), were detected among them. The van A resistance gene seems to be widespread in enterococci of natural ecosystems, in addition to clinical settings, and it would be interesting to track the routes of dissemination of these resistant microorganisms that have great importance in public health.…”