title: Genetic features and molecular epidemiology of Enterococcus faecium isolated in two university hospitals in Brazil.
abstract: The global emergence of vancomycin-resistant Enterococcus faecium (VREfm) has been characterized by a clonal spread of strains belonging to clonal complex 17 (CC17). Genetic features and clonal relationships of 53 VREfm isolated from patients in 2 hospitals in Ribeirao Preto, São Paulo, Brazil, during 2005-2010 were determined as a contribution to the Brazilian evolutionary history of these nosocomial pathogens. All isolates were daptomycin susceptible, vancomycin-resistant, and had the vanA gene. The predominant virulence genes were acm and esp. Only 5 VREfm isolated in 2005-2006 had intact Tn1546, while 81% showed Tn1546 with deleted left extremity and insertion of IS1251 between the vanS and vanH genes. Multilocus sequence typing analysis permitted the identification of 9 different sequence types (STs), with 5 being new ones (656, 657, 658, 659, and 660). Predominant STs were ST412 and ST478, all belonging to CC17, except ST658. This is the first report of the ST78 in Brazil.
authors.affiliation: Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Leila Priscilla Pinheiro
authors.initials: LP
authors.lastname: da Silva
authors.forename: André
authors.initials: A
authors.lastname: Pitondo-Silva
authors.forename: Roberto
authors.initials: R
authors.lastname: Martinez
authors.forename: Ana Lúcia
authors.initials: AL
authors.lastname: da Costa Darini
mesh_terms: D018829:Adhesins, Bacterial / Q000235:genetics; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics; D001938:Brazil / Q000453:epidemiology; D019729:Carbon-Oxygen Ligases / Q000235:genetics; D004251:DNA Transposable Elements; D004269:DNA, Bacterial / Q000235:genetics; D017576:Daptomycin / Q000494:pharmacology; D016984:Enterococcus faecium / Q000145:classification* / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D006785:Hospitals, University; D006801:Humans; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D058885:Multilocus Sequence Typing; D014640:Vancomycin / Q000494:pharmacology; D020713:Vancomycin Resistance; D037521:Virulence Factors / Q000235:genetics
chemical_list: C473793:Acm protein, Enterococcus faecium; D018829:Adhesins, Bacterial; D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D004251:DNA Transposable Elements; D004269:DNA, Bacterial; C071437:VanA ligase, Bacteria; D037521:Virulence Factors; D014640:Vancomycin; D019729:Carbon-Oxygen Ligases; D017576:Daptomycin