Host Specificity of Vancomycin‐Resistant<i>Enterococcus faecium</i>

Willems, Rob J. L.; Top, Janetta; den, Nicole Braak van; Belkum, Alex van; Endtz, Hubert P.; Mevius, Dik; Stobberingh, Ellen E.; Bogaard, A. van den; Embden, J. D. A. Van

doi:10.1086/315752

Cited by 156 publications

(195 citation statements)

References 62 publications

(68 reference statements)

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“…Although previous molecular epidemiologic studies on limited numbers of strains suggested host specificity and overrepresentation of certain clones in hospital outbreaks (14,15), these studies did not elucidate the patterns of evolutionary descent among VRE. We determined the population structure of 411 VRE and vancomycin-susceptible E. faecium (VSE) isolates by using multilocus sequence typing (MLST), explored the evolutionary origin of epidemic isolates associated with documented hospital outbreaks and other isolates, and assessed the association with ampicillin resistance and the presence of a recently discovered putative pathogenicity island (PAI) in E. faecium (16).…”

mentioning

confidence: 85%

Global Spread of Vancomycin-resistantEnterococcus faeciumfrom Distinct Nosocomial Genetic Complex

Willems

Top

Santen

et al. 2005

Emerg. Infect. Dis.

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confidence: 85%

Global Spread of Vancomycin-resistantEnterococcus faeciumfrom Distinct Nosocomial Genetic Complex

Willems

Top

Santen

et al. 2005

Emerg. Infect. Dis.

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485

400

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“…Using molecular typing, it was shown that outbreak strains isolated from hospitalized patients are genetically different from VREF strains present in the fecal flora of nonhospitalized individuals (29). Interestingly, strains recovered from nonhospitalized persons are genetically related to pig isolates (29).…”

mentioning

confidence: 99%

Acquisition and Duration of Vancomycin-Resistant Enterococcal Carriage in Relation to Strain Type

Mascini¹,

Jalink²,

Kamp-Hopmans³

et al. 2003

J Clin Microbiol

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In May 2000, the first outbreak of vancomycin-resistant Enterococcus faecium (VREF) was detected in the University Medical Center Utrecht in the nephrology ward. The question arose why some VREF strains spread among hospitalized patients, whereas other strains do not. Thirty patients who were found to be colonized with VREF between May and November 2000 were included in the study. Molecular typing confirmed that 19 of them carried an identical epidemic strain which harbored the esp gene while 11 were colonized by nonepidemic strains that were all esp negative. Acquisition of the outbreak strain was significantly associated with diabetes mellitus, renal transplantation, and extensive use of antibiotics, especially cephalosporins, in the 2-month period before the first isolation of VREF. To establish the duration of colonization, prospective surveillance of VREF carriage for a 6-month period starting from the first isolation of VREF was realized for 20 patients. After 6 months, VREF was still recovered from 60% of carriers of the outbreak strain versus 20% of carriers of nonepidemic strains (P < 0.01). However, antibiotic use during the follow-up period was significantly higher by carriers of the outbreak strain than by carriers of nonepidemic strains. The fact that the outbreak strain was recovered for a longer period of time than nonepidemic strains may facilitate dissemination of the strain. The results support a careful restrictive antibiotic policy for wards at risk for spread of VREF and implementation of isolation precautions for patients who are colonized with esp-positive outbreak strains.

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“…To our knowledge, type I in this study likely corresponds to type B of the European isolates reported by Willems et al (20), except for the IS1542 insertion. Type II corresponds to type E. In particular, type IIc appears to be identical to subtype E13 (14,20). All types of the Tn1546-like elements in this study harbored IS1542, which is restricted to Europe, mainly the United Kingdom.…”

Section: Vol 42 2004mentioning

confidence: 63%

“…Until recently, IS1216V, IS1542, IS1251, and IS1476 were reported in VanA VRE. IS1216V is known to be ubiquitous in vanA elements (9,20), whereas the other three IS elements appear to be geographically restricted. For example, IS1542 is frequently found in clinical and poultry VRE isolates from the United Kingdom and Ireland (14,22).…”

Section: Vol 42 2004mentioning

confidence: 99%

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Distribution of Insertion Sequences Associated with Tn 1546 -Like Elements among Enterococcus faecium Isolates from Patients in Korea

Huh

Lee

et al. 2004

J Clin Microbiol

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The vanA gene cluster is carried as a part of Tn1546-like elements. The genetic diversity in Tn1546-like elements has been documented previously. The differences described thus far have included the integration of insertion sequence (IS) elements IS1216V, IS1251, IS1476, and IS1542. Among these, IS1216V has been reported to be widespread in VanA enterococci of diverse geographic areas, whereas IS1542 and IS1476 have been reported only in the United Kingdom and Canada, respectively. We investigated the distribution of ISs among 20 vanA-containing Enterococcus faecium isolates from human patients in nine different university hospitals in Korea. Pulsed-field gel electrophoresis (PFGE) was performed to identify the clonality of the isolates. Moreover, PCR amplification of the internal regions of Tn1546 was performed for structural analysis of the van gene, and both DNA strands of the PCR amplicons were directly sequenced by the dideoxy termination method. The PFGE patterns revealed a high degree of clonal diversity. Structural analyses of the van gene detected IS1542 and IS1216V in the genomes of all 20 isolates, whereas it did not detect IS1476 or IS1251 in the genomes of any of the isolates. In addition, IS19 was detected in the vanS-vanH intergenic region of one isolate. These data indicate that identification of the IS within a vanA gene cluster could be a useful tool in epidemiological investigations. In addition, the distribution of ISs associated with Tn1546-like elements among the Korean isolates is therefore similar to that among European vancomycin-resistant enterococci.

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Host Specificity of Vancomycin‐ResistantEnterococcus faecium

Cited by 156 publications

References 62 publications

Global Spread of Vancomycin-resistantEnterococcus faeciumfrom Distinct Nosocomial Genetic Complex

Global Spread of Vancomycin-resistantEnterococcus faeciumfrom Distinct Nosocomial Genetic Complex

Acquisition and Duration of Vancomycin-Resistant Enterococcal Carriage in Relation to Strain Type

Distribution of Insertion Sequences Associated with Tn 1546 -Like Elements among Enterococcus faecium Isolates from Patients in Korea

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