Molecular characterization of resistance, virulence and clonality in vancomycin-resistant Enterococcus faecium and Enterococcus faecalis : A hospital-based study in Beijing, China

Yang, Jinming; Li, Tong; Ning, Yuping; Shao, Dong-hua; Liu, Jing; Wang, Shuqin; Li, Guowei

doi:10.1016/j.meegid.2015.05.012

Cited by 62 publications

(43 citation statements)

References 39 publications

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“…Our results indicated that E. faecalis isolates carried more virulence genes in comparison to various reports [49181925262728]. These differences probably reflect variability in the types of samples or geographic regions.…”

Section: Discussionsupporting

confidence: 41%

High Incidence of Virulence Factors Among ClinicalEnterococcus faecalisIsolates in Southwestern Iran

et al. 2017

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BackgroundOver the past two decades, enterococci have emerged as an important agent responsible for hospital acquired infection. Several virulence factors contribute to the adherence, colonization, evasion of the host immune response, and pathogenicity and severity of the infection. Enterococcus faecalis is the most common and virulent species causing infections in hospitalized patients. The aim of the present study was to examine the prevalence of genes encoding virulence factors and antimicrobial resistance patterns of E. faecalis strains isolated from hospitalized patients in Shiraz, south west of Iran.Materials and MethodsA total of 51 E. faecalis isolates from the urine, blood, pleural fluid, peritoneal fluid, eye discharge, endotracheal tube (ETT) and transjugular intrahepatic portosystemic shunt (TIPS) specimens of patients were identified by phenotypic and genotypic methods. Antimicrobial sensitivity tests and detection of virulence factors were performed using standard methods.ResultsThe efa and asa1 were the most frequently detected gene (100%) among the isolates, followed by esp (94.1%), ace (90.2%), gelE (80.4%), cylA (64.7%), and hyl (51%). More than half of the isolates (52.9%) were high level gentamicin resistant (HLGR). Vancomycin resistance was observed among 23 (45.1%) isolates. The lowest antimicrobial activity was related to erythromycin (3.9%), tetracycline (5.9%) and ciprofloxacin (9.8%). No isolate was found resistant to fosfomycin and linezolid.ConclusionOur data indicated a high incidence of virulence factors among E. faecalis strains isolated from clinical samples. Colonization of drug resistant virulent isolates in hospital environment may lead to life threatening infection in hospitalized patients. Therefore, infection control procedures should be performed.

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Section: Discussionsupporting

confidence: 41%

High Incidence of Virulence Factors Among ClinicalEnterococcus faecalisIsolates in Southwestern Iran

et al. 2017

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“…35 The most common Q/D resistance of enterococci occurs with macrolide-lincosamide-streptogramin B (MLSb), which is mediated by the erm genes. 8 Owing to changes in the 23S ribosomal region, the dimethylase enzyme encoded by these genes reduces the binding of the MLSb-group antibiotics to the target region. 4,8 Streptogramin A resistance is exhibited in the form of enzymatic inactivation of the antibiotic, which is mediated by the vatD and vatE genes.…”

Section: Dovepressmentioning

confidence: 99%

Antibiotic Resistance and Molecular Epidemiology of Vancomycin-Resistant Enterococci in a Tertiary Care Hospital in Turkey

Aşgın

Otlu

2020

IDR

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Purpose: Vancomycin-resistant enterococci (VRE) have become a global health threat in the last two decades. In this study, we aimed to determine antibiotic resistance using phenotypic and genotypic methods in VRE strains obtained from inpatients and to investigate clonal relatedness among strains. Methods: Identification and antibiotic susceptibility of 47 VRE strains obtained from inpatients at Karabuk University Hospital from 2014 to 2015 were determined using the BD Phoenix™ automated microbiology system. Vancomycin resistance genes (Van A and B) were detected by polymerase chain reaction. Clonal relatedness among the strains was evaluated by pulsed-field gel electrophoresis (PFGE). Results: All 47 VRE strains obtained from rectal (n=35), blood (n=7), and urine (n=5) samples were confirmed as Enterococcus faecium; they were resistant to ampicillin, gentamicin, vancomycin, and teicoplanin. One E. faecium isolate was intermediately resistant to linezolid. No strain was resistant to quinupristin-dalfopristin or daptomycin. Only vanA was detected among strains. According to the PFGE results, 31 of 47 strains were clonally related with a clustering rate of 66%. No common clone was detected. Conclusion: VRE infections are associated with high mortality, morbidity, and healthcare expenditures. Increasing resistance to last-line drugs, such as linezolid and daptomycin, among VRE strains is a great concern. Therefore, comprehensive measures should be performed to reduce VRE colonization. Although there was no common clone VRE outbreak, polyclonal spread was observed in our hospital. The high clustering rate indicated cross-contamination. Thus, a more effective infection control program should be implemented.

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“…[21][22][23][24][25][26] However, the number of studies examining the clonal background of vanA-positive E. faecium strains is still low in China. 27 We report the complete genome sequence of a clinically isolated E. faecium ST78 strain harboring vanA from a patient in Hangzhou, China. Genome alignment of the whole sequence of pVRE1-VanA with the NCBI GenBank database indicated that pVRE1-VanA was a novel plasmid.…”

Section: Discussionmentioning

confidence: 99%

Emergence of vanA-Type Vancomycin-Resistant Enterococcus faecium ST 78 Strain with a rep2-Type Plasmid Carrying a Tn1546-Like Element Isolated from a Urinary Tract Infection in China

Sun

Wang

et al. 2020

IDR

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The emergence of vancomycin-resistant enterococci (VRE) dramatically narrows therapeutic options. Although the prevalence of VRE in China has maintained a low level, VRE outbreaks have been reported in some tertiary hospitals in the developed areas of China. The clonal background of vanA-positive Enterococcus faecium strains has not been well characterized in China. Here, we report the whole-genome sequence of a vanA-type vancomycin-resistant E. faecium belonging to sequence type (ST) 78 isolated from a urinary tract infection in China. Patients and Methods: A vancomycin-resistant E. faecium was isolated from a 66-year-old male patient diagnosed with brainstem hemorrhage. Antibiotic susceptibility assays were performed according to the guidelines of the Clinical and Laboratory Standards Institute (CLSI). Complete genome sequencing was performed using both the HiSeq TM 4000 platform and the MinION platform. Plasmid, genomic and phylogenetic relationship analysis were further performed. Results: E. faecium VRE1 was resistant to all antimicrobials tested except for tetracyclines and oxazolidinones. The whole genome of E. faecium VRE1 was composed of one chromosomal DNA and four plasmids. Two virulence genes and five antimicrobial resistance genes were identified. In silico multilocus sequence typing (MLST) showed that it belonged to ST78 (clonal complex CC17), a well-known epidemic clone that is widespread in Europe and the United States. Three antimicrobial resistance genes, including aminoglycoside resistance genes ant(6)-Ia and aph(3ʹ)-III ; and glycopeptide resistance gene vanA, were located on a rep2-type plasmid carrying a Tn1546like element that has not been reported. The most closely related strain harboring a similar plasmid backbone was recovered from fodder sample in China that differed by 178 cgMLST loci. Conclusion: Our study characterizes the genomic feature of a vancomycin-resistant E. faecium ST78 strain harboring a vanA-carrying plasmid in China. The ST78 clonal group possessed the potential to emerge as a successful vanA-carrying epidemic lineage in China.

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Molecular characterization of resistance, virulence and clonality in vancomycin-resistant Enterococcus faecium and Enterococcus faecalis : A hospital-based study in Beijing, China

Cited by 62 publications

References 39 publications

High Incidence of Virulence Factors Among ClinicalEnterococcus faecalisIsolates in Southwestern Iran

High Incidence of Virulence Factors Among ClinicalEnterococcus faecalisIsolates in Southwestern Iran

<p>Antibiotic Resistance and Molecular Epidemiology of Vancomycin-Resistant Enterococci in a Tertiary Care Hospital in Turkey</p>

<p>Emergence of <em>vanA</em>-Type Vancomycin-Resistant <em>Enterococcus faecium</em> ST 78 Strain with a rep2-Type Plasmid Carrying a Tn1546-Like Element Isolated from a Urinary Tract Infection in China</p>

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