Environmental survival of vancomycin-sensitive ampicillin-resistant Enterococcus faecium (AREfm)

Wagenvoort, J. H. T.; Brauwer, E.I.G.B. De; Penders, R. J. R.; Linden, C. J. Van Der; Willems, Rob J. L.; Top, Janetta; Bonten, Marc J. M.

doi:10.1007/s10096-015-2430-x

Cited by 13 publications

(9 citation statements)

References 11 publications

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“…To survive in a hospital environment the adaptive traits of high tenacity and resistance to disinfection procedures are important for the hospital VRE lineages, allowing them to survive for many years in a hospital environment [95]. Enterococci are therefore excellent indicators of environmental contamination [96,97]. Enterococci are often isolated from high-contact points such as bed rails, over-bed tables, blood-pressure cuffs, alarm buttons, toilet seats and door handles [98].…”

Section: Infection Control Measuresmentioning

confidence: 99%

“…Contaminated surfaces represent hidden reservoirs, from which enterococci may re-emerge and colonize patients that are subsequently admitted to the contaminate room [7]. In attempts to eradicate persistent reservoirs with VRE, intensified cleaning measures like targeted cleaning of environmental surfaces using high concentrations of sodium chloride or decontamination with hydrogen peroxide vapor should be used [96,100].…”

Section: Infection Control Measuresmentioning

confidence: 99%

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Enterococcus faecium: from microbiological insights to practical recommendations for infection control and diagnostics

Zhou

Willems

Friedrich

et al. 2020

Antimicrob Resist Infect Control

120

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Early in its evolution, Enterococcus faecium acquired traits that allowed it to become a successful nosocomial pathogen. E. faecium inherent tenacity to build resistance to antibiotics and environmental stressors that allows the species to thrive in hospital environments. The continual wide use of antibiotics in medicine has been an important driver in the evolution of E. faecium becoming a highly proficient hospital pathogen. For successful prevention and reduction of nosocomial infections with vancomycin resistant E. faecium (VREfm), it is essential to focus on reducing VREfm carriage and spread. The aim of this review is to incorporate microbiological insights of E. faecium into practical infection control recommendations, to reduce the spread of hospital-acquired VREfm (carriage and infections). The spread of VREfm can be controlled by intensified cleaning procedures, antibiotic stewardship, rapid screening of VREfm carriage focused on high-risk populations, and identification of transmission routes through accurate detection and typing methods in outbreak situations. Further, for successful management of E. faecium, continual innovation in the fields of diagnostics, treatment, and eradication is necessary.

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Section: Infection Control Measuresmentioning

confidence: 99%

Section: Infection Control Measuresmentioning

confidence: 99%

Enterococcus faecium: from microbiological insights to practical recommendations for infection control and diagnostics

Zhou

Willems

Friedrich

et al. 2020

Antimicrob Resist Infect Control

120

View full text Add to dashboard Cite

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“…Infections caused by Enterococcus faecium have increasingly been reported since the early 1980s’, as have the number of antibiotic resistant isolates of this species ( Top et al, 2007 ). Currently, most clinical strains of E. faecium are ampicillin resistant (AmpR), which often also acquire transferable mobile genetic elements, some encoding vancomycin resistance ( Arias and Murray, 2012 ; Wagenvoort et al, 2015 ). Multidrug resistant E. faecium isolates are responsible for infections associated with treatment failures and high mortality rates ( Arias et al, 2010 ; Centers for Disease Control and Prevention, 2013 ).…”

Section: Introductionmentioning

confidence: 99%

Co-diversification of Enterococcus faecium Core Genomes and PBP5: Evidences of pbp5 Horizontal Transfer

et al. 2016

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Ampicillin resistance has greatly contributed to the recent dramatic increase of a cluster of human adapted Enterococcus faecium lineages (ST17, ST18, and ST78) in hospital-based infections. Changes in the chromosomal pbp5 gene have been associated with different levels of ampicillin susceptibility, leading to protein variants (designated as PBP5 C-types to keep the nomenclature used in previous works) with diverse degrees of reduction in penicillin affinity. Our goal was to use a comparative genomics approach to evaluate the relationship between the diversity of PBP5 among E. faecium isolates of different phylogenomic groups as well as to assess the pbp5 transferability among isolates of disparate clonal lineages. The analyses of 78 selected E. faecium strains as well as published E. faecium genomes, suggested that the diversity of pbp5 mirrors the phylogenomic diversification of E. faecium. The presence of identical PBP5 C-types as well as similar pbp5 genetic environments in different E. faecium lineages and clones from quite different geographical and environmental origin was also documented and would indicate their horizontal gene transfer among E. faecium populations. This was supported by experimental assays showing transfer of large (≈180–280 kb) chromosomal genetic platforms containing pbp5 alleles, ponA (transglycosilase) and other metabolic and adaptive features, from E. faecium donor isolates to suitable E. faecium recipient strains. Mutation profile analysis of PBP5 from available genomes and strains from this study suggests that the spread of PBP5 C-types might have occurred even in the absence of a significant ampicillin resistance phenotype. In summary, genetic platforms containing pbp5 sequences were stably maintained in particular E. faecium lineages, but were also able to be transferred among E. faecium clones of different origins, emphasizing the growing risk of further spread of ampicillin resistance in this nosocomial pathogen.

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“…E. faecium also has the ability to persist for long periods of time on synthetic surfaces like table tops, handrails, doorknobs and other medical surfaces [ 9 – 11 ]. The ability of E. faecium to spread via fomites is thus proposed to play a critical role in the inter-patient spread of E. faecium in hospital settings [ 12 – 14 ].…”

Section: Introductionmentioning

confidence: 99%

Conditionally essential genes for survival during starvation in Enterococcus faecium E745

et al. 2020

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Background The nosocomial pathogen Enterococcus faecium can survive for prolonged periods of time on surfaces in the absence of nutrients. This trait is thought to contribute to the ability of E. faecium to spread among patients in hospitals. There is currently a lack of data on the mechanisms that are responsible for the ability of E. faecium to survive in the absence of nutrients. Results We performed a high-throughput transposon mutant library screening (Tn-seq) to identify genes that have a role in long-term survival during incubation in phosphate-buffered saline (PBS) at 20 °C. A total of 24 genes were identified by Tn-seq to contribute to survival in PBS, with functions associated with the general stress response, DNA repair, metabolism, and membrane homeostasis. The gene which was quantitatively most important for survival in PBS was usp (locus tag: EfmE745_02439), which is predicted to encode a 17.4 kDa universal stress protein. After generating a targeted deletion mutant in usp, we were able to confirm that usp significantly contributes to survival in PBS and this defect was restored by in trans complementation. The usp gene is present in 99% of a set of 1644 E. faecium genomes that collectively span the diversity of the species. Conclusions We postulate that usp is a key determinant for the remarkable environmental robustness of E. faecium. Further mechanistic studies into usp and other genes identified in this study may shed further light on the mechanisms by which E. faecium can survive in the absence of nutrients for prolonged periods of time.

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Environmental survival of vancomycin-sensitive ampicillin-resistant Enterococcus faecium (AREfm)

Cited by 13 publications

References 11 publications

Enterococcus faecium: from microbiological insights to practical recommendations for infection control and diagnostics

Enterococcus faecium: from microbiological insights to practical recommendations for infection control and diagnostics

Co-diversification of Enterococcus faecium Core Genomes and PBP5: Evidences of pbp5 Horizontal Transfer

Conditionally essential genes for survival during starvation in Enterococcus faecium E745

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