title: Molecular characterization of clinical and environmental isolates of vancomycin-resistant Enterococcus faecium and Enterococcus faecalis from a teaching hospital in Wales.
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 Enterococcus faecium and 45 Enterococcus faecalis) 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 E. faecium and four isolates of E. faecalis) were obtained from 14 patients. All study isolates were subjected to PFGE typing and their van genotypes were determined by using multiplex PCR. The vanA PCR product (231 bp) was evident in 146 (92 %) of 158 VRE isolates; the remaining 12 isolates (8 %) were positive for the vanB gene. All isolates of E. faecalis were found to be vanA-positive. In total, 16 PFGE banding profiles (pulsotypes) were observed for environmental isolates of E. faecium, whilst eight pulsotypes were found for isolates of E. faecalis. 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 E. faecium (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.
authors.affiliation: Department of Oral Surgery, Medicine and Pathology, Dental School, University of Wales College of Medicine, Heath Park, Cardiff CF14 4XY, UK 2Department of Infection Prevention and Control, Cardiff and Vale NHS Trust, Heath Park, Cardiff CF14 4XN, UK.
authors.forename: Tomoari
authors.initials: T
authors.lastname: Kuriyama
authors.affiliation: Department of Oral Surgery, Medicine and Pathology, Dental School, University of Wales College of Medicine, Heath Park, Cardiff CF14 4XY, UK 2Department of Infection Prevention and Control, Cardiff and Vale NHS Trust, Heath Park, Cardiff CF14 4XN, UK.
authors.forename: David W
authors.initials: DW
authors.lastname: Williams
authors.affiliation: Department of Oral Surgery, Medicine and Pathology, Dental School, University of Wales College of Medicine, Heath Park, Cardiff CF14 4XY, UK 2Department of Infection Prevention and Control, Cardiff and Vale NHS Trust, Heath Park, Cardiff CF14 4XN, UK.
authors.forename: Mital
authors.initials: M
authors.lastname: Patel
authors.affiliation: Department of Oral Surgery, Medicine and Pathology, Dental School, University of Wales College of Medicine, Heath Park, Cardiff CF14 4XY, UK 2Department of Infection Prevention and Control, Cardiff and Vale NHS Trust, Heath Park, Cardiff CF14 4XN, UK.
authors.forename: Michael A O
authors.initials: MAO
authors.lastname: Lewis
authors.affiliation: Department of Oral Surgery, Medicine and Pathology, Dental School, University of Wales College of Medicine, Heath Park, Cardiff CF14 4XY, UK 2Department of Infection Prevention and Control, Cardiff and Vale NHS Trust, Heath Park, Cardiff CF14 4XN, UK.
authors.forename: Lynda E
authors.initials: LE
authors.lastname: Jenkins
authors.affiliation: Department of Oral Surgery, Medicine and Pathology, Dental School, University of Wales College of Medicine, Heath Park, Cardiff CF14 4XY, UK 2Department of Infection Prevention and Control, Cardiff and Vale NHS Trust, Heath Park, Cardiff CF14 4XN, UK.
authors.forename: Dylan W
authors.initials: DW
authors.lastname: Hill
authors.affiliation: Department of Oral Surgery, Medicine and Pathology, Dental School, University of Wales College of Medicine, Heath Park, Cardiff CF14 4XY, UK 2Department of Infection Prevention and Control, Cardiff and Vale NHS Trust, Heath Park, Cardiff CF14 4XN, UK.
authors.forename: Ian K
authors.initials: IK
authors.lastname: Hosein
mesh_terms: D001426:Bacterial Proteins / Q000235:genetics; D019729:Carbon-Oxygen Ligases / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D013293:Enterococcus faecalis / Q000145:classification* / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification; D016984:Enterococcus faecium / Q000145:classification* / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification; D004783:Environmental Microbiology; D005838:Genotype; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology*; D006784:Hospitals, Teaching; D006801:Humans; D016133:Polymerase Chain Reaction; D020713:Vancomycin Resistance / Q000235:genetics; D014852:Wales
chemical_list: D001426:Bacterial Proteins; C071437:VanA ligase, Bacteria; C079913:VanB protein, Enterococcus; D019729:Carbon-Oxygen Ligases