title: Identification of high-risk enterococcal clonal complexes: global dispersion and antibiotic resistance.
abstract: Vancomycin-resistant Enterococcus faecium spread dramatically in hospital settings in the USA in the 1990s and reached endemicity at the turn of the century. Similarly, rising prevalence rates are currently observed in several European countries, with prevalence rates of greater than 10% reported in seven of these. On the basis of multilocus sequence typing (MLST), the population structure of E. faecium was elucidated and the existence of a distinct high-risk enterococcal clonal complex, designated clonal complex-17 (CC17), which is associated with the majority of hospital outbreaks and clinical infections in five continents, was revealed. This complex is correlated with ampicillin and quinolone resistance and with the presence of a putative pathogenicity island. Preliminary MLST data suggest that similar hospital-adapted complexes might also exist in E. faecalis.
authors.affiliation: Eijkman-Winkler Institute for Microbiology, Infectious Diseases and Inflammation, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
authors.forename: Helen L
authors.initials: HL
authors.lastname: Leavis
authors.forename: Marc J M
authors.initials: MJ
authors.lastname: Bonten
authors.forename: Rob J L
authors.initials: RJ
authors.lastname: Willems
mesh_terms: D000668:Ampicillin Resistance / Q000235:genetics; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D005075:Biological Evolution; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology*; D004196:Disease Outbreaks; D004351:Drug Resistance / Q000235:genetics; D024881:Drug Resistance, Bacterial; D016984:Enterococcus faecium / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000472:pathogenicity; D005060:Europe / Q000453:epidemiology; D005798:Genes, Bacterial / Q000235:genetics; D044404:Genomic Islands; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology*; D006801:Humans; D017720:Molecular Epidemiology; D015363:Quinolones / Q000494:pharmacology; D014481:United States / Q000453:epidemiology; D014774:Virulence / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D015363:Quinolones