[Glycopeptide-resistant Enterococcus faecium. Analysis of the resistance genotype, virulence and genetic lines].
OBJECTIVE
The objective of this study was to analyse the genotypic characteristics of all Enterococcus isolates with acquired vancomycin resistance (VRE) recovered in the Hospital Clinic (Barcelona, Spain) in a period of three years and two months.


METHODS
All VRE isolated in the referred Hospital in the period January 2004-March 2007 were included in the study. The vancomycin resistance mechanism was investigated, as well as other antibiotic resistance mechanisms. Isolates were also typed by pulsed-field-gel-electrophoresis (PFGE) and multi-locus-sequence-typing (MLST).


RESULTS
Thirty-nine VRE were recovered, all being identified as E. faecium, representing 2% of total enterococci obtained in that period. Thirty-eight of them carried the vanA gene, and one isolate the vanB2 gene. The 39 VRE were classified into 13 different pulsotypes (A-M), with one main pulsotype, A, which included 13 isolates. The sequence type was identified by MLST in 24 VRE (with unrelated or closely-related PFGE patterns), and they were ascribed to the clonal complex CC17, but two classified as CC9. All VRE showed a multiresistance phenotype, including, in most cases ampicillin, ciprofloxacin, erythromycin, streptomycin, gentamicin, kanamycin and chloramphenicol, harbouring multiple antibiotic resistance genes. The presence of esp and/or hyl genes was identified in 37 VRE.


CONCLUSIONS
All VRE, but one, showed the vanA genotype and they were mostly ascribed to the high-risk clonal complex CC17.
Área de Bioquímica y Biología Molecular, Universidad de La Rioja, Logroño, España.
María
M
López
Míriam J
MJ
Alvarez-Martínez
Francesc
F
Marco
Carmen
C
Torres
D003428:Cross Infection / Q000382:microbiology; D016984:Enterococcus faecium / Q000187:drug effects* / Q000235:genetics / Q000472:pathogenicity; D005838:Genotype; D006020:Glycopeptides / Q000494:pharmacology; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology; D006761:Hospitals; D006801:Humans; D020713:Vancomycin Resistance / Q000235:genetics*; D014774:Virulence / Q000235:genetics
D006020:Glycopeptides