title: Molecular and epidemiological study of the first outbreak of vanB type vancomycin-resistant Enterococcus faecalis in Japan.
abstract: In July, 1999, an outbreak of vancomycin-resistant Enterococcus faecalis (VREF) with the vanB genotype occurred for the first time in Japan at Hokushin General Hospital, Nakano City, Nagano Prefecture. Four VREF strains were isolated from the clinical specimens of four inpatients, and 16 VREF strains were isolated by the screening of asymptomatic carriers and by surveillance of the hospital environment. All of the isolates possessed vanB genes. In a pulsed-field gel electrophoresis analysis, 19 out of 20 VREF isolates exhibited the indistinguishable restriction endonuclease digestion patterns of the chromosomal DNA. Additional investigation by Southern hybridization using the vanB probe implied that the vanB gene of these 19 isolates was encoded on a 110-kb plasmid. These findings indicate that the outbreak was principally caused by a single clone. The restriction endonuclease digestion patterns of the remaining single isolate was different from those of the other isolates. The vanB gene was encoded on the chromosome.
authors.affiliation: School of Allied Medical Sciences, Sinshu University, Matsumoto 390-8621, Japan. koana@gipac.shinshu-u.ac.jp
authors.lastname: Oana
authors.forename: Y
authors.initials: Y
authors.lastname: Kawakami
authors.forename: M
authors.initials: M
authors.lastname: Ohnishi
authors.forename: M
authors.initials: M
authors.lastname: Ishikawa
authors.forename: M
authors.initials: M
authors.lastname: Hirota
authors.forename: M
authors.initials: M
authors.lastname: Tozuka
authors.forename: K
authors.initials: K
authors.lastname: Atarashi
authors.forename: K
authors.initials: K
authors.lastname: Baba
authors.forename: K
authors.initials: K
authors.lastname: Fujiki
authors.forename: M
authors.initials: M
authors.lastname: Okazaki
authors.forename: T
authors.initials: T
authors.lastname: Honda
authors.forename: T
authors.initials: T
authors.lastname: Hayashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001426:Bacterial Proteins / Q000235:genetics*; D015139:Blotting, Southern; D004262:DNA Restriction Enzymes; D004196:Disease Outbreaks; D004352:Drug Resistance, Microbial; D016521:Electrophoresis, Gel, Pulsed-Field; D013293:Enterococcus faecalis / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D005260:Female; D005838:Genotype; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D010957:Plasmids; D020713:Vancomycin Resistance
chemical_list: D001426:Bacterial Proteins; C079913:VanB protein, Enterococcus; D004262:DNA Restriction Enzymes