Large clonal outbreak of multidrug-resistant CC17 ST17 Enterococcus faecium containing Tn5382 in a Spanish hospital
Objectives A large clonal outbreak of multidrug-resistant CC17 ST17 Enterococcus faecium containing Tn5382 in a hospital in the north of Spain is described. Methods We characterized vancomycin-resistant E. faecium isolates from 10 infected and 40 colonized inpatients from a single hospital by PFGE,...
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| Veröffentlicht in: | Journal of antimicrobial chemotherapy 2009-01, Vol.63 (1), p.17-20 |
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| creator | Valdezate, Sylvia Labayru, Cristina Navarro, Ana Mantecón, María A. Ortega, María Coque, Teresa M. García, Moisés Saéz-Nieto, Juan A. |
| description | Objectives A large clonal outbreak of multidrug-resistant CC17 ST17 Enterococcus faecium containing Tn5382 in a hospital in the north of Spain is described. Methods We characterized vancomycin-resistant E. faecium isolates from 10 infected and 40 colonized inpatients from a single hospital by PFGE, multiple-locus variable-number tandem-repeat analysis (MLVA) and multilocus sequence typing (MLST). Genes encoding antibiotic resistance (ampicillin, aminoglycosides, macrolides, quinupristin/dalfopristin, quinolones, tetracycline) and putative virulence traits were analysed. Results All isolates showed highly similar PFGE profiles and were assigned to the type MT1 by MLVA and to ST17 (CC17) by MLST. The Tn5382 type identified in all isolates was linked to pbp5 and contained a 5 bp deletion and 10 point mutations within the intergenic vanSB–vanYB region. Other resistance genes identified were erm(B), mef(E), tet(M), ant(6′)-Ia, aph(3′)-IIIa and aac(6′)-Ie-aph(2′′)-Ia. All isolates carried the unexpressed tet(M) gene. The high level of ciprofloxacin resistance was attributable to the first described Gly-61 and Ile-80 mutations in ParC and the Tyr-83 or Arg-83 mutations in GyrA. All isolates contained esp. The presence of hyl was variable. Conclusions A large clonal outbreak caused by multidrug-resistant CC17 E. faecium containing pbp5–Tn5382 is described. The persistence of this clone, which has been recovered from both hospital and community settings since 2005, and the possibility of transferring this Tn5382 to other epidemic ampicillin-resistant clonal types currently circulating in Spain might contribute to increasing the prevalence of vancomycin-resistant enterococci in our area. This study constitutes the first description of mef(E) in E. faecium. |
| doi_str_mv | 10.1093/jac/dkn449 |
| format | Article |
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Methods We characterized vancomycin-resistant E. faecium isolates from 10 infected and 40 colonized inpatients from a single hospital by PFGE, multiple-locus variable-number tandem-repeat analysis (MLVA) and multilocus sequence typing (MLST). Genes encoding antibiotic resistance (ampicillin, aminoglycosides, macrolides, quinupristin/dalfopristin, quinolones, tetracycline) and putative virulence traits were analysed. Results All isolates showed highly similar PFGE profiles and were assigned to the type MT1 by MLVA and to ST17 (CC17) by MLST. The Tn5382 type identified in all isolates was linked to pbp5 and contained a 5 bp deletion and 10 point mutations within the intergenic vanSB–vanYB region. Other resistance genes identified were erm(B), mef(E), tet(M), ant(6′)-Ia, aph(3′)-IIIa and aac(6′)-Ie-aph(2′′)-Ia. All isolates carried the unexpressed tet(M) gene. The high level of ciprofloxacin resistance was attributable to the first described Gly-61 and Ile-80 mutations in ParC and the Tyr-83 or Arg-83 mutations in GyrA. All isolates contained esp. The presence of hyl was variable. Conclusions A large clonal outbreak caused by multidrug-resistant CC17 E. faecium containing pbp5–Tn5382 is described. The persistence of this clone, which has been recovered from both hospital and community settings since 2005, and the possibility of transferring this Tn5382 to other epidemic ampicillin-resistant clonal types currently circulating in Spain might contribute to increasing the prevalence of vancomycin-resistant enterococci in our area. This study constitutes the first description of mef(E) in E. faecium.</description><identifier>ISSN: 0305-7453</identifier><identifier>EISSN: 1460-2091</identifier><identifier>DOI: 10.1093/jac/dkn449</identifier><identifier>PMID: 19001448</identifier><identifier>CODEN: JACHDX</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents ; Bacteria ; Bacterial Typing Techniques ; Biological and medical sciences ; Carrier State - microbiology ; Case studies ; Cluster Analysis ; Cross Infection - epidemiology ; Cross Infection - microbiology ; DNA Fingerprinting ; DNA Transposable Elements ; DNA, Bacterial - chemistry ; DNA, Bacterial - genetics ; Drug resistance ; Drug Resistance, Multiple, Bacterial ; Enterococcus faecium ; Enterococcus faecium - classification ; Enterococcus faecium - drug effects ; Enterococcus faecium - isolation & purification ; Genes, Bacterial ; Genotype ; genotypes ; Gram-Positive Bacterial Infections - epidemiology ; Gram-Positive Bacterial Infections - microbiology ; Hospitals ; Humans ; Infections ; Medical sciences ; mef(E) ; molecular resistance mechanisms ; Molecular Sequence Data ; Pharmacology. Drug treatments ; Sequence Analysis, DNA ; Spain - epidemiology ; tet(M) ; vanB2 ; Virulence Factors - genetics</subject><ispartof>Journal of antimicrobial chemotherapy, 2009-01, Vol.63 (1), p.17-20</ispartof><rights>The Author 2008. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org 2009</rights><rights>2009 INIST-CNRS</rights><rights>The Author 2008. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c477t-fe87f3fac1481c7cb409057c3b700079f16c963289486f8125d1bab5df7cac423</citedby><cites>FETCH-LOGICAL-c477t-fe87f3fac1481c7cb409057c3b700079f16c963289486f8125d1bab5df7cac423</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,1585,4025,27928,27929,27930</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21096117$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19001448$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Valdezate, Sylvia</creatorcontrib><creatorcontrib>Labayru, Cristina</creatorcontrib><creatorcontrib>Navarro, Ana</creatorcontrib><creatorcontrib>Mantecón, María A.</creatorcontrib><creatorcontrib>Ortega, María</creatorcontrib><creatorcontrib>Coque, Teresa M.</creatorcontrib><creatorcontrib>García, Moisés</creatorcontrib><creatorcontrib>Saéz-Nieto, Juan A.</creatorcontrib><title>Large clonal outbreak of multidrug-resistant CC17 ST17 Enterococcus faecium containing Tn5382 in a Spanish hospital</title><title>Journal of antimicrobial chemotherapy</title><addtitle>J Antimicrob Chemother</addtitle><description>Objectives A large clonal outbreak of multidrug-resistant CC17 ST17 Enterococcus faecium containing Tn5382 in a hospital in the north of Spain is described. Methods We characterized vancomycin-resistant E. faecium isolates from 10 infected and 40 colonized inpatients from a single hospital by PFGE, multiple-locus variable-number tandem-repeat analysis (MLVA) and multilocus sequence typing (MLST). Genes encoding antibiotic resistance (ampicillin, aminoglycosides, macrolides, quinupristin/dalfopristin, quinolones, tetracycline) and putative virulence traits were analysed. Results All isolates showed highly similar PFGE profiles and were assigned to the type MT1 by MLVA and to ST17 (CC17) by MLST. The Tn5382 type identified in all isolates was linked to pbp5 and contained a 5 bp deletion and 10 point mutations within the intergenic vanSB–vanYB region. Other resistance genes identified were erm(B), mef(E), tet(M), ant(6′)-Ia, aph(3′)-IIIa and aac(6′)-Ie-aph(2′′)-Ia. All isolates carried the unexpressed tet(M) gene. The high level of ciprofloxacin resistance was attributable to the first described Gly-61 and Ile-80 mutations in ParC and the Tyr-83 or Arg-83 mutations in GyrA. All isolates contained esp. The presence of hyl was variable. Conclusions A large clonal outbreak caused by multidrug-resistant CC17 E. faecium containing pbp5–Tn5382 is described. The persistence of this clone, which has been recovered from both hospital and community settings since 2005, and the possibility of transferring this Tn5382 to other epidemic ampicillin-resistant clonal types currently circulating in Spain might contribute to increasing the prevalence of vancomycin-resistant enterococci in our area. This study constitutes the first description of mef(E) in E. faecium.</description><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Bacteria</subject><subject>Bacterial Typing Techniques</subject><subject>Biological and medical sciences</subject><subject>Carrier State - microbiology</subject><subject>Case studies</subject><subject>Cluster Analysis</subject><subject>Cross Infection - epidemiology</subject><subject>Cross Infection - microbiology</subject><subject>DNA Fingerprinting</subject><subject>DNA Transposable Elements</subject><subject>DNA, Bacterial - chemistry</subject><subject>DNA, Bacterial - genetics</subject><subject>Drug resistance</subject><subject>Drug Resistance, Multiple, Bacterial</subject><subject>Enterococcus faecium</subject><subject>Enterococcus faecium - classification</subject><subject>Enterococcus faecium - drug effects</subject><subject>Enterococcus faecium - isolation & purification</subject><subject>Genes, Bacterial</subject><subject>Genotype</subject><subject>genotypes</subject><subject>Gram-Positive Bacterial Infections - epidemiology</subject><subject>Gram-Positive Bacterial Infections - microbiology</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infections</subject><subject>Medical sciences</subject><subject>mef(E)</subject><subject>molecular resistance mechanisms</subject><subject>Molecular Sequence Data</subject><subject>Pharmacology. Drug treatments</subject><subject>Sequence Analysis, DNA</subject><subject>Spain - epidemiology</subject><subject>tet(M)</subject><subject>vanB2</subject><subject>Virulence Factors - genetics</subject><issn>0305-7453</issn><issn>1460-2091</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0U-L1DAYBvAgijuuXvwAEgQ9CHWTJk3a4zKsM8qAyI5_2Et4myazmWmTmrSg394sM-yCB728ufx4wvs-CL2k5D0lDbvYg77oDp7z5hFaUC5IUZKGPkYLwkhVSF6xM_QspT0hRFSiforOaEMI5bxeoLSBuDNY98FDj8M8tdHAAQeLh7mfXBfnXRFNcmkCP-Hlkkp8vc3jyk8mBh20nhO2YLSbB6yDn8B553d46ytWl9h5DPh6BO_SLb4NaXQT9M_REwt9Mi9O7zn6-uFqu1wXm8-rj8vLTaG5lFNhTS0ts6Apr6mWuuWkIZXUrJV5E9lYKnQjWFk3vBa2pmXV0RbaqrNSg-YlO0dvj7ljDD9nkyY1uKRN34M3YU5KCMlzUPVfWJJSlrK-g6__gvswx3y5bKgUkuaDZ_TuiHQMKUVj1RjdAPG3okTdFaZyYepYWMavTolzO5jugZ4ayuDNCUDS0NsIXrt078ocKCiVDy7M478_LI4uV2p-3UuIByUkk5Va_7hR3z6t1vLL6ru6YX8AO6K5Cg</recordid><startdate>200901</startdate><enddate>200901</enddate><creator>Valdezate, Sylvia</creator><creator>Labayru, Cristina</creator><creator>Navarro, Ana</creator><creator>Mantecón, María A.</creator><creator>Ortega, María</creator><creator>Coque, Teresa M.</creator><creator>García, Moisés</creator><creator>Saéz-Nieto, Juan A.</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7QO</scope><scope>7T7</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>200901</creationdate><title>Large clonal outbreak of multidrug-resistant CC17 ST17 Enterococcus faecium containing Tn5382 in a Spanish hospital</title><author>Valdezate, Sylvia ; Labayru, Cristina ; Navarro, Ana ; Mantecón, María A. ; Ortega, María ; Coque, Teresa M. ; García, Moisés ; Saéz-Nieto, Juan A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c477t-fe87f3fac1481c7cb409057c3b700079f16c963289486f8125d1bab5df7cac423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Antibiotics. Antiinfectious agents. Antiparasitic agents</topic><topic>Bacteria</topic><topic>Bacterial Typing Techniques</topic><topic>Biological and medical sciences</topic><topic>Carrier State - microbiology</topic><topic>Case studies</topic><topic>Cluster Analysis</topic><topic>Cross Infection - epidemiology</topic><topic>Cross Infection - microbiology</topic><topic>DNA Fingerprinting</topic><topic>DNA Transposable Elements</topic><topic>DNA, Bacterial - chemistry</topic><topic>DNA, Bacterial - genetics</topic><topic>Drug resistance</topic><topic>Drug Resistance, Multiple, Bacterial</topic><topic>Enterococcus faecium</topic><topic>Enterococcus faecium - classification</topic><topic>Enterococcus faecium - drug effects</topic><topic>Enterococcus faecium - isolation & purification</topic><topic>Genes, Bacterial</topic><topic>Genotype</topic><topic>genotypes</topic><topic>Gram-Positive Bacterial Infections - epidemiology</topic><topic>Gram-Positive Bacterial Infections - microbiology</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Infections</topic><topic>Medical sciences</topic><topic>mef(E)</topic><topic>molecular resistance mechanisms</topic><topic>Molecular Sequence Data</topic><topic>Pharmacology. Drug treatments</topic><topic>Sequence Analysis, DNA</topic><topic>Spain - epidemiology</topic><topic>tet(M)</topic><topic>vanB2</topic><topic>Virulence Factors - genetics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Valdezate, Sylvia</creatorcontrib><creatorcontrib>Labayru, Cristina</creatorcontrib><creatorcontrib>Navarro, Ana</creatorcontrib><creatorcontrib>Mantecón, María A.</creatorcontrib><creatorcontrib>Ortega, María</creatorcontrib><creatorcontrib>Coque, Teresa M.</creatorcontrib><creatorcontrib>García, Moisés</creatorcontrib><creatorcontrib>Saéz-Nieto, Juan A.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of antimicrobial chemotherapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Valdezate, Sylvia</au><au>Labayru, Cristina</au><au>Navarro, Ana</au><au>Mantecón, María A.</au><au>Ortega, María</au><au>Coque, Teresa M.</au><au>García, Moisés</au><au>Saéz-Nieto, Juan A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Large clonal outbreak of multidrug-resistant CC17 ST17 Enterococcus faecium containing Tn5382 in a Spanish hospital</atitle><jtitle>Journal of antimicrobial chemotherapy</jtitle><addtitle>J Antimicrob Chemother</addtitle><date>2009-01</date><risdate>2009</risdate><volume>63</volume><issue>1</issue><spage>17</spage><epage>20</epage><pages>17-20</pages><issn>0305-7453</issn><eissn>1460-2091</eissn><coden>JACHDX</coden><abstract>Objectives A large clonal outbreak of multidrug-resistant CC17 ST17 Enterococcus faecium containing Tn5382 in a hospital in the north of Spain is described. Methods We characterized vancomycin-resistant E. faecium isolates from 10 infected and 40 colonized inpatients from a single hospital by PFGE, multiple-locus variable-number tandem-repeat analysis (MLVA) and multilocus sequence typing (MLST). Genes encoding antibiotic resistance (ampicillin, aminoglycosides, macrolides, quinupristin/dalfopristin, quinolones, tetracycline) and putative virulence traits were analysed. Results All isolates showed highly similar PFGE profiles and were assigned to the type MT1 by MLVA and to ST17 (CC17) by MLST. The Tn5382 type identified in all isolates was linked to pbp5 and contained a 5 bp deletion and 10 point mutations within the intergenic vanSB–vanYB region. Other resistance genes identified were erm(B), mef(E), tet(M), ant(6′)-Ia, aph(3′)-IIIa and aac(6′)-Ie-aph(2′′)-Ia. All isolates carried the unexpressed tet(M) gene. The high level of ciprofloxacin resistance was attributable to the first described Gly-61 and Ile-80 mutations in ParC and the Tyr-83 or Arg-83 mutations in GyrA. All isolates contained esp. The presence of hyl was variable. Conclusions A large clonal outbreak caused by multidrug-resistant CC17 E. faecium containing pbp5–Tn5382 is described. The persistence of this clone, which has been recovered from both hospital and community settings since 2005, and the possibility of transferring this Tn5382 to other epidemic ampicillin-resistant clonal types currently circulating in Spain might contribute to increasing the prevalence of vancomycin-resistant enterococci in our area. This study constitutes the first description of mef(E) in E. faecium.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>19001448</pmid><doi>10.1093/jac/dkn449</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Antibiotics. Antiinfectious agents. Antiparasitic agents Bacteria Bacterial Typing Techniques Biological and medical sciences Carrier State - microbiology Case studies Cluster Analysis Cross Infection - epidemiology Cross Infection - microbiology DNA Fingerprinting DNA Transposable Elements DNA, Bacterial - chemistry DNA, Bacterial - genetics Drug resistance Drug Resistance, Multiple, Bacterial Enterococcus faecium Enterococcus faecium - classification Enterococcus faecium - drug effects Enterococcus faecium - isolation & purification Genes, Bacterial Genotype genotypes Gram-Positive Bacterial Infections - epidemiology Gram-Positive Bacterial Infections - microbiology Hospitals Humans Infections Medical sciences mef(E) molecular resistance mechanisms Molecular Sequence Data Pharmacology. Drug treatments Sequence Analysis, DNA Spain - epidemiology tet(M) vanB2 Virulence Factors - genetics |
| title | Large clonal outbreak of multidrug-resistant CC17 ST17 Enterococcus faecium containing Tn5382 in a Spanish hospital |
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