title: Molecular typing of vancomycin-resistant Enterococcus faecium with an automated repetitive sequence-based PCR microbial typing system compared with pulsed-field gel electrophoresis and multilocus sequence typing.
abstract: BACKGROUND
  Pulsed-field gel electrophoresis (PFGE) is the main typing method used for the molecular typing of vancomycin-resistant Enterococcus faecium (VREfm). However, more rapid and unambiguous typing methods are needed. DiversiLab, a repetitive sequence-based PCR (rep-PCR), offers an alternative method for strain typing.
  
  
  METHODS
  Thirty-nine VREfm isolates with known epidemiological relationships were characterized by semi-automated rep-PCR (DiversiLab), PFGE, and multilocus sequence typing (MLST).
  
  
  RESULTS
  The DiversiLab results were analysed in 2 ways: first relying solely on the DiversiLab software, and second by DiversiLab analysis combined with manual interpretation. The analysis with interpretation yielded more DiversiLab profiles, correlated better with PFGE and MLST, and grouped the isolates better according to their relatedness in time and space. However, most of the DiversiLab groups also included isolates with different PFGE and MLST types.
  
  
  CONCLUSIONS
  DiversiLab provides rapid information when investigating a potential hospital outbreak. However, the interpretation of E. faecium DiversiLab results cannot be fully automated and is not always straightforward. Other typing methods may be necessary to confirm the analysis.
authors.affiliation: Department of Infectious Disease Surveillance and Control, Antimicrobial Resistance Unit, National Institute for Health and Welfare, THL, Helsinki, Finland. minna.karden-lilja@thl.fi
authors.forename: Minna
authors.initials: M
authors.lastname: Kardén-Lilja
authors.forename: Jaana
authors.initials: J
authors.lastname: Vuopio
authors.forename: Markku
authors.initials: M
authors.lastname: Koskela
authors.forename: Päivi
authors.initials: P
authors.lastname: Tissari
authors.forename: Saara
authors.initials: S
authors.lastname: Salmenlinna
mesh_terms: D004352:Drug Resistance, Microbial; D016521:Electrophoresis, Gel, Pulsed-Field / Q000379:methods*; D016984:Enterococcus faecium / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology*; D006801:Humans; D058885:Multilocus Sequence Typing / Q000379:methods*; D016133:Polymerase Chain Reaction / Q000379:methods*; D014640:Vancomycin / Q000494:pharmacology
chemical_list: D014640:Vancomycin