title: A cluster of VanD vancomycin-resistant Enterococcus faecium: molecular characterization and clinical epidemiology.
abstract: VanD-mediated glycopeptide resistance has been reported for an isolate of Enterococcus faecium, BM4339. Three clinical isolates of vancomycin-resistant E. faecium collected from 3 patients during a 6-week period in 1993 had agar dilution MICs of vancomycin and teicoplanin of 128 and 4 microg/mL, respectively. Polymerase chain reaction (PCR) using degenerate primers complementary to genes encoding d-Ala-d-X ligases yielded a 630-bp product that was similar to the published partial sequence of vanD. By use of inverse PCR, vanD, vanHD, and two partial flanking open-reading frames were sequenced. The deduced amino acid sequence of VanD showed 67% identity with VanA and VanB. vanD appeared to be located on the chromosome and was not transferable to other enterococci. The 3 isolates were indistinguishable by pulsed-field gel electrophoresis and differed from BM4339. No other isolates carrying vanD were found in a subset of 875 recent US isolates of vancomycin-resistant enterococci.
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
authors.forename: B E
authors.initials: BE
authors.lastname: Ostrowsky
authors.forename: N C
authors.initials: NC
authors.lastname: Clark
authors.forename: C
authors.initials: C
authors.lastname: Thauvin-Eliopoulos
authors.forename: L
authors.initials: L
authors.lastname: Venkataraman
authors.forename: M H
authors.initials: MH
authors.lastname: Samore
authors.forename: F C
authors.initials: FC
authors.lastname: Tenover
authors.forename: G M
authors.initials: GM
authors.lastname: Eliopoulos
authors.forename: R C
authors.initials: RC
authors.lastname: Moellering
authors.forename: H S
authors.initials: HS
authors.lastname: Gold
mesh_terms: D000595:Amino Acid Sequence; D001426:Bacterial Proteins / Q000235:genetics*; D001483:Base Sequence; D002874:Chromosome Mapping; D017931:DNA Primers; D016984:Enterococcus faecium / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology; D006801:Humans; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D008969:Molecular Sequence Data; D016366:Open Reading Frames; D010453:Peptide Synthases / Q000235:genetics; D016133:Polymerase Chain Reaction; D016415:Sequence Alignment; D017386:Sequence Homology, Amino Acid; D014640:Vancomycin / Q000494:pharmacology; D020713:Vancomycin Resistance
chemical_list: D001426:Bacterial Proteins; D017931:DNA Primers; D014640:Vancomycin; D010453:Peptide Synthases; C122181:VanD protein, Enterococcus faecium