title: Phenotypic and genotypic characterization of VanA Enterococcus isolated during the first nosocomial outbreak in Brazil.
abstract: We report the phenotypic and genotypic characterization of 50 VanA Enterococcus clinical isolates from infected patients and 97 isolates from colonized patients obtained during a nosocomial outbreak in a single hospital in São Paulo, Brazil during 1998. The identification of strains to the species level by conventional biochemical and phenotypic tests and by multiplex PCR assay had 100% agreement. Both E. faecalis and E. faecium were isolated from patients during this outbreak. The vanA genotype was confirmed by PCR. Antibiotic susceptibility testing showed that E. faecium isolates are generally less susceptible to antibiotics than E. faecalis. By PCR, 24 of 26 VRE strains tested carried the Tn1546 element. Pulsed-field gel electrophoresis identified five distinct patterns for E. faecalis (A, B, C, D, E) and three for E. faecium (M, N, and O). A single PFGE pattern was identified in the majority of strains of each species and does not discriminate between case and carrier isolates.
authors.affiliation: Laboratory of Bacteriology, Institute Adolfo Lutz, São Paulo, Brazil. cobo@ial.sp.gov.br
authors.forename: Rosemeire C
authors.initials: RC
authors.lastname: Zanella
authors.forename: Maria Cristina C
authors.initials: MC
authors.lastname: Brandileone
authors.forename: Sérgio
authors.initials: S
authors.lastname: Bokermann
authors.forename: Samanta C G
authors.initials: SC
authors.lastname: Almeida
authors.forename: Fábio
authors.initials: F
authors.lastname: Valdetaro
authors.forename: Fábio
authors.initials: F
authors.lastname: Vitório
authors.forename: Maria de Fátima A
authors.initials: Mde F
authors.lastname: Moreira
authors.forename: Margarete
authors.initials: M
authors.lastname: Villins
authors.forename: Reinaldo
authors.initials: R
authors.lastname: Salomão
authors.forename: Antonio Carlos C
authors.initials: AC
authors.lastname: Pignatari
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics*; D001938:Brazil / Q000453:epidemiology; D019729:Carbon-Oxygen Ligases / Q000235:genetics*; D003428:Cross Infection / Q000382:microbiology*; D017931:DNA Primers; D016521:Electrophoresis, Gel, Pulsed-Field; D013293:Enterococcus faecalis / Q000235:genetics*; D005838:Genotype; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology*; D006801:Humans; D008826:Microbial Sensitivity Tests; D010641:Phenotype; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014640:Vancomycin / Q000494:pharmacology; D020713:Vancomycin Resistance / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D017931:DNA Primers; C071437:VanA ligase, Bacteria; D014640:Vancomycin; D019729:Carbon-Oxygen Ligases