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Molecular Characterization of Vancomycin-Resistant Enterococcus faecium Isolated from Intensive Care Units

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Abstract

To assess the molecular characterization of disseminated vancomycin-resistant enterococci (VRE) in the intensive care units, 546 enterococci isolates were collected from different clinical samples in a prospective observational study. The results showed that a total number of 33 isolates (6 %) were resistant to vancomycin. Most of the VRE isolates 11 (34 %) were isolated from intensive care units (ICUs). 18 (55 %) VRE isolates were obtained from urinary tract infections. The results from pulsed-field gel electrophoresis showed five common types (CT) and 13 single types (ST) among the VRE isolates. The analysis showed two and one major CTs and ST among the ICUs isolates, respectively. Tn1546 transposon was analyzed using ClaI-digested long PCR (L-PCR) RFLP followed by sequencing. The results showed the presence of two different lineages of transposon among the two clonal groups. Lineage 1 with the arrangement of Tn1546 prototype in the first clonal group and the second lineage with 13 kb harboring two insertion sequences, IS1216 V and IS1542. DNA hybridization showed that vanA gene in all VRE isolates, with an exception of one isolate, was present in the same location on the genome. Overall, the results suggest that a few VRE clonal types were disseminated in ICUs in hospitals in Iran which were able to transfer their vanA with high conjugation frequency.

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References

  1. Clewell DB (1981) Plasmids, drug resistance, and gene transfer in genus transfer in genus Streptococcus. Microbiol Rev 45:409–436

    CAS  PubMed Central  PubMed  Google Scholar 

  2. Clinical and Laboratory Standards Institute (CLSI) (2010) Performance standards for antimicrobial susceptibility testing; 20th informational supplement. CLSI document M100-S20, vol 30. Clinical and Laboratory Standards Institute, Wayne

    Google Scholar 

  3. Clinical and Laboratory Standards Institute (CLSI) (2006) Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically. CLSI document M7-A7. Clinical and Laboratory Standards Institute, Wayne

    Google Scholar 

  4. Facklam RR, Collins MD (1989) Identification of Enterococcus species isolated from human infections by a conventional test scheme. J Clin Microbiol 27:731–734

    CAS  PubMed Central  PubMed  Google Scholar 

  5. Freitas AR, Novais C, Tedim AP, Francia MV, Baquero F, Peixe L, Coque TM (2013) Microevolutionaryeventsinvolvingnarrowhostplasmidsinfluenceslocalfixation of vancomycin-resistance in Enterococcus populations. PLoS ONE 8:e60589

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  6. Fridkin SK, Edwards JR, Courval JM, Hill H, Tenover FC, Lawton R, Gaynes RP, McGowan JE Jr, Intensive Care Antimicrobial Resistance Epidemiology (ICARE) Project and the National Nosocomial Infections Surveillance (NNIS) System Hospitals (2001) The effect of vancomycin and third-generation cephalosporins on prevalence of vancomycin-resistant enterococci in 126 U.S. adult intensive care units. Ann Intern Med 135:175–183

    Article  CAS  PubMed  Google Scholar 

  7. Fridkin SK, Steward CD, Edwards JR, Pryor ER, McGowan JE Jr, Archibald LK, Gaynes RP, Tenover FC (1999) Surveillance of antimicrobial use and antimicrobial resistance in United States hospitals: project ICARE phase 2. Project Intensive Care Antimicrobial Resistance Epidemiology (ICARE) hospitals. Clin Infect Dis 29:245–252

    Article  CAS  PubMed  Google Scholar 

  8. Fridkin SK, Hill HA, Volkova NV, Edwards JR, Lawton RM, Gaynes RP, McGowan JE Jr, Intensive Care Antimicrobial Resistance Epidemiology Project Hospitals (2002) Temporal changes in prevalence of antimicrobial resistance in 23 U.S. hospitals. Emerg Infect Dis 8:697–701

    Article  PubMed Central  PubMed  Google Scholar 

  9. Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes JM (1988) CDC definitions for nosocomial infections. Am J Infect Control 16:128–140

    Article  CAS  PubMed  Google Scholar 

  10. Hariharan S, Nanduri SB, Moseley HS, Areti KY, Jonnalagadda R (2003) Spectrum of microbes and antimicrobial resistance in a surgical intensive care unit, Barbados. Am J Infect Control 31:280–287

    Article  PubMed  Google Scholar 

  11. Huang SS, Rifas-Shiman SL, Pottinger JM, Herwaldt LA, Zembower TR, Noskin GA, Cosgrove SE, Perl TM, Curtis AB, Tokars JL, Diekema DJ, Jernigan JA, Hinrichsen VL, Yokoe DS, Platt R, Centers for Disease Control and Prevention Epicenters Program (2007) Improving the assessment of vancomycin-resistant enterococci by routine screening. J Infect Dis 195:339–346

    Article  CAS  PubMed  Google Scholar 

  12. Jahangiri S, Talebi M, Eslami G, Pourshafie MR (2010) Prevalence of virulence factors and antibiotic resistance in vancomycin-resistant Enterococcus faecium isolated from sewage and clinical samples in Iran. Indian J Med Microbiol 28:337–341

    Article  CAS  PubMed  Google Scholar 

  13. Kariyama R, Mitsuhata R, Chow JW, Clewell DB, Kumon H (2000) Simple and reliable Multiplex PCR assay for surveillance isolates of vancomycin resistant enterococci. J Clin Microbiol 38:3092–3095

    CAS  PubMed Central  PubMed  Google Scholar 

  14. Lund B, Agvald-Ohman C, Hultberg A, Edlund C (2002) Frequent transmission of enterococcal strains between mechanically ventilated patients treated at an intensive care unit. J Clin Microbiol 40:2084–2088

    Article  PubMed Central  PubMed  Google Scholar 

  15. Pan SC, Wang JT, Chen YC, Chang YY, Chen ML, Chang SC (2012) Incidence of and risk factors for infection or colonization of vancomycin-resistant enterococci in patients in the intensive care unit. PLoS ONE 7:e47297

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. Pourshafie MR, Talebi M, Saifi M, Katouli M, Eshraghi S, Kühn I, Möllby R (2008) Clonal heterogeneity of clinical isolates of vancomycin-resistant Enterococcus faecium with unique vans. Trop Med Int Health 13:722–727

    Article  PubMed  Google Scholar 

  17. Rodríguez-Baño J, Ramírez E, Muniain MA, Santos J, Joyanes P, González F, García-Sánchez M, Martínez-Martínez L (2005) Colonization by high-level aminoglycoside-resistant enterococci in intensive care unit patients: epidemiology and clinical relevance. J Hosp Infect 60:353–359

    Article  PubMed  Google Scholar 

  18. Rossini FA, Fagnani R, Leichsenring ML, Dantas SR, Cardoso LG, Levy CE, Moretti ML, Trabasso P (2012) Successful prevention of the transmission of vancomycin-resistant enterococci in a Brazilian public teaching hospital. Rev Soc Bras Med Trop 45:184–188

    Article  PubMed  Google Scholar 

  19. Song JY, Cheong HJ, Jo YM, Choi WS, Noh JY, Heo JY, Kim WJ (2009) Vancomycin-resistant Enterococcus colonization before admission to the intensive care unit: a clinico-epidemiologic analysis. Am J Infect Control 37:734–740

    Article  CAS  PubMed  Google Scholar 

  20. Streit JM, Jones RN, Sader HS, Fritsche TR (2004) Assessment of pathogen occurrences and resistance profiles among infected patients in the intensive care unit: report from the SENTRY Antimicrobial Surveillance Program (North America, 2001). Int J Antimicrob Agents 24:111–118

    Article  CAS  PubMed  Google Scholar 

  21. Talebi M, Pourshafie MR, Katouli M, Möllby R (2008) Molecular structure and transferability of Tn1546-like elements in Enterococcus faecium isolates from clinical, sewage, and surface water samples in Iran. Appl Environ Microb 74:1350–1356

    Article  CAS  Google Scholar 

  22. Talebi M, Rahimi F, Katouli M, Möllby R, Pourshafie MR (2008) Epidemiological link between wastewater and human vancomycin-resistant Enterococcus faecium isolates. Curr Microbiol 56:468–473

    Article  CAS  PubMed  Google Scholar 

  23. Toledano H, Schlesinger Y, Raveh D, Rudensky B, Attias D, Eidelman AI, Yinnon AM (2000) Prospective surveillance of vancomycin-resistant enterococci in a neonatal intensive care unit. Eur J Clin Microbiol Infect Dis 19:282–287

    Article  CAS  PubMed  Google Scholar 

  24. Zhanel GG, DeCorby M, Laing N, Weshnoweski B, Vashisht R, Tailor F, Nichol KA, Wierzbowski A, Baudry PJ, Karlowsky JA, Lagacé-Wiens P, Walkty A, McCracken M, Mulvey MR, Johnson J, Canadian Antimicrobial Resistance Alliance (CARA), Hoban DJ (2008) Antimicrobial-resistant pathogens in intensive care units in Canada: results of the Canadian National Intensive Care Unit (CAN-ICU) study, 2005–2006. Antimicrob Agents Chemother 52:1430–1437

    Article  CAS  PubMed Central  PubMed  Google Scholar 

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Correspondence to Mohammad R. Pourshafie.

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Talebi, M., Sadeghi, J. & Pourshafie, M.R. Molecular Characterization of Vancomycin-Resistant Enterococcus faecium Isolated from Intensive Care Units. Curr Microbiol 68, 615–620 (2014). https://doi.org/10.1007/s00284-013-0517-0

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