title: Clonal dissemination and colony morphotype variation of vancomycin-resistant Enterococcus faecium isolates in metropolitan Detroit, Michigan.
abstract: Thirty-two isolates of vancomycin-resistant Enterococcus faecium (VRE) recovered from 25 patients hospitalized at six hospitals in the metropolitan Detroit, Mich., area over a 32-month period were examined for relatedness by repetitive-sequence PCR (rep-PCR). All isolates were shown to carry the vanA gene by PCR. The rep-PCR patterns generated from each isolate showed that the first three VRE isolates obtained from hospital A between June 1992 and February 1994 were distinct strains. Thereafter, all VRE isolates originating from hospital A and those collected from five other area hospitals had identical rep-PCR patterns. On detailed examination, subcultures of 25 of the 32 VRE isolates produced two distinct colony types characterized phenotypically by a rough and a smooth appearance, respectively. Both colony types retained the vanA locus and the rep-PCR pattern of the primary isolate. These data suggest that a single strain of VRE with the capacity to produce two colonial variants has been disseminated to several Detroit-area hospitals. The clinical significance of the colonial morphotypes is unclear.
authors.affiliation: Henry Ford Health System, Detroit, Michigan 48202, USA.
authors.forename: W M
authors.initials: WM
authors.lastname: Dunne
authors.forename: W
authors.initials: W
authors.lastname: Wang
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics; D015373:Bacterial Typing Techniques; D019729:Carbon-Oxygen Ligases; D004352:Drug Resistance, Microbial / Q000235:genetics; D016984:Enterococcus faecium / Q000145:classification / Q000166:cytology* / Q000187:drug effects* / Q000235:genetics; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology*; D006801:Humans; D008025:Ligases / Q000235:genetics; D008824:Michigan; D010641:Phenotype; D016133:Polymerase Chain Reaction; D014640:Vancomycin / Q000494:pharmacology*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; C071437:VanA ligase, Bacteria; D014640:Vancomycin; D008025:Ligases; D019729:Carbon-Oxygen Ligases