1887

Abstract

The present study describes the first molecular characterization of environmental and clinical isolates of vancomycin-resistant enterococci (VRE) in Wales. Over a 3-month period (May–July 2000), 134 isolates of VRE (89 and 45 ) were isolated from the patient environment of the University Hospital of Wales (UHW) in Cardiff, Wales, UK. In addition, over the same time-period, 24 clinical isolates of VRE (20 isolates of and four isolates of ) were obtained from 14 patients. All study isolates were subjected to PFGE typing and their genotypes were determined by using multiplex PCR. The PCR product (231 bp) was evident in 146 (92 %) of 158 VRE isolates; the remaining 12 isolates (8 %) were positive for the gene. All isolates of were found to be -positive. In total, 16 PFGE banding profiles (pulsotypes) were observed for environmental isolates of , whilst eight pulsotypes were found for isolates of . Some of these pulsotypes were isolated from multiple sites, whereas others were more restricted in their distribution. Eleven pulsotypes were evident for clinical isolates and eight of these (representing 11 isolates) were also encountered in environmental isolates. Eleven clinical isolates of (55 %) shared an identical pulsotype that was not detected in environmental isolates. These results demonstrate a heterogeneous environmental population of VRE and an association of certain strains with clinical isolates. Predominance of a single pulsotype (not detected in the environment) amongst clinical isolates suggests non-environmental transmission between patients.

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2003-09-01
2024-03-28
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References

  1. Bartie K. L, Wilson M. J, Williams D. W, Lewis M. A. O. 2000; Macrorestriction fingerprinting of ‘‘ Streptococcus milleri ’’ group bacteria by pulsed-field gel electrophoresis. J Clin Microbiol 38:2141–2149
    [Google Scholar]
  2. Bell J. M, Paton J. C, Turnidge J. 1998; Emergence of vancomycin-resistant enterococci in Australia: phenotypic and genotypic characteristics of isolates. J Clin Microbiol 36:2187–2190
    [Google Scholar]
  3. Bonten M. J, Willems R, Weinstein R. A. 2001; Vancomycin-resistant enterococci: why are they here, and where do they come from?. Lancet Infect Dis 1:314–325 [CrossRef]
    [Google Scholar]
  4. Cetinkaya Y, Falk P, Mayhall C. G. 2000; Vancomycin-resistant enterococci. Clin Microbiol Rev 13:686–707 [CrossRef]
    [Google Scholar]
  5. Falk P. S, Winnike J, Woodmansee C, Desai M, Mayhall C. G. 2000; Outbreak of vancomycin-resistant enterococci in a burn unit. Infect Control Hosp Epidemiol 21:575–582 [CrossRef]
    [Google Scholar]
  6. Gambarotto K, Ploy M.-C, Turlure P, Grélaud C, Martin C, Bordessoule D, Denis F. 2000; Prevalence of vancomycin-resistant enterococci in fecal samples from hospitalized patients and nonhospitalized controls in a cattle-rearing area of France. J Clin Microbiol 38:620–624
    [Google Scholar]
  7. Goossens H. 1998; Spread of vancomycin-resistant enterococci: differences between the United States and Europe. Infect Control Hosp Epidemiol 19:546–551 [CrossRef]
    [Google Scholar]
  8. Gordillo M. E, Singh K. V, Murray B. E. 1993; Comparison of ribotyping and pulsed-field gel electrophoresis for subspecies differentiation of strains of Enterococcus faecalis . J Clin Microbiol 31:1570–1574
    [Google Scholar]
  9. Hayden M. K. 2000; Insights into the epidemiology and control of infection with vancomycin-resistant enterococci. Clin Infect Dis 31:1058–1065 [CrossRef]
    [Google Scholar]
  10. Homan W. L, Tribe D, Poznanski S, Li M, Hogg G, Spalburg E, van Embden J. D. A, Willems R. J. L. 2002; Multilocus sequence typing scheme for Enterococcus faecium . J Clin Microbiol 40:1963–1971 [CrossRef]
    [Google Scholar]
  11. Kawalec M, Gniadkowski M, Hryniewicz W. 2000; Outbreak of vancomycin-resistant enterococci in a hospital in Gdańsk, Poland, due to horizontal transfer of different Tn 1546 -like transposon variants and clonal spread of several strains. J Clin Microbiol 38:3317–3322
    [Google Scholar]
  12. McKessar S. J, Berry A. M, Bell J. M, Turnidge J. D, Paton J. C. 2000; Genetic characterization of vanG , a novel vancomycin resistance locus of Enterococcus faecalis . Antimicrob Agents Chemother 44:3224–3228 [CrossRef]
    [Google Scholar]
  13. Mundy L. M, Sahm D. F, Gilmore M. 2000; Relationships between enterococcal virulence and antimicrobial resistance. Clin Microbiol Rev 13:513–522 [CrossRef]
    [Google Scholar]
  14. Murray B. E. 2000; Vancomycin-resistant enterococcal infections. N Engl J Med 342:710–721 [CrossRef]
    [Google Scholar]
  15. Murray P. R, Baron E. J, Pfaller M. A, Tenover F. C, Yolken R. H. 1999 Manual of Clinical Microbiology , 7th edn. Washington, DC: American Society for Microbiology;
    [Google Scholar]
  16. National Committee for Clinical Laboratory Standards 2000 Performance Standards for Antimicrobial Disk Susceptibility Tests, Approved Standard, 7th edn (M2-A7. Villanova: National Committee for Clinical Laboratory Standards;
    [Google Scholar]
  17. Scagnelli M, Pellizer G, de Lalla F. 7 other authors 2001; Epidemiological analysis of vancomycin-resistant enterococci in a large tertiary-care hospital in Northern Italy. Eur J Clin Microbiol Infect Dis 20:609–616
    [Google Scholar]
  18. Tenover F. C, Arbeit R. D, Goering R. V, Mickelsen P. A, Murray B. E, Persing D. H, Swaminathan B. 1995; Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 33:2233–2239
    [Google Scholar]
  19. Weber D. J, Rutala W. A. 1997; Role of environmental contamination in the transmission of vancomycin-resistant enterococci. Infect Control Hosp Epidemiol 18:306–309 [CrossRef]
    [Google Scholar]
  20. Willems R. J, Homan W, Top J. 9 other authors 2001; Variant esp gene as a marker of a distinct genetic lineage of vancomycin-resistant Enterococcus faecium spreading in hospitals. Lancet 357:853–855 [CrossRef]
    [Google Scholar]
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