title: Vancomycin-resistant enterococci among haemodialysis patients in Portugal: prevalence and molecular characterization of resistance, virulence and clonality.
abstract: BACKGROUND
  Vancomycin-resistant enterococci (VRE) among haemodialysis patients has increased rapidly and, to date, there is no report of this incidence in Portugal.
  
  
  METHODS
  A total of 121 faecal samples were collected from haemodialysis patients, and then tested for VRE. Antimicrobial resistance, virulence and multilocus sequence typing (MLST) were studied.
  
  
  RESULTS
  VRE prevalence was 3.3%. Three VRE isolates, Enterococcus faecium, Enterococcus faecalis and Enterococcus raffinosus, were multi-resistant and vanA-positive. E. faecium and E. faecalis belonged to CC17 and CC2, respectively.
  
  
  CONCLUSIONS
  Haemodialysis patients in Portugal are colonized with virulent, multi-resistant enterococci from high-risk clonal complexes, representing a public health concern.
authors.affiliation: Institute for Biotechnology and Bioengineering, Centre of Genomics and Biotechnology, University of Trás-os-Montes and Alto Douro, 5001-801 Vila Real, Portugal; Department of Genetics and Biotechnology, University of Trás-os-Montes and Alto Douro, 5001-801 Vila Real, Portugal; Centre of Studies of Animal and Veterinary Sciences, University of Trás-os-Montes and Alto Douro, 5001-801 Vila Real, Portugal; Veterinary Science Department, University of Trás-os-Montes and Alto Douro, 5001-801 Vila Real, Portugal.
authors.forename: Susana
authors.initials: S
authors.lastname: Correia
authors.affiliation: Fresenius Medical Care, Nephrocare Lumiar, Rua José da Costa Pedreira n.° 8, 1750-130 Lisboa, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Ponce
authors.affiliation: National Reference Laboratory of Antimicrobial Resistances, Department of Infectious Diseases, National Institute of Health Dr Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisboa, Portugal.
authors.forename: Daniela
authors.initials: D
authors.lastname: Jones-Dias
authors.affiliation: National Reference Laboratory of Antimicrobial Resistances, Department of Infectious Diseases, National Institute of Health Dr Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisboa, Portugal.
authors.forename: Manuela
authors.initials: M
authors.lastname: Caniça
authors.affiliation: Institute for Biotechnology and Bioengineering, Centre of Genomics and Biotechnology, University of Trás-os-Montes and Alto Douro, 5001-801 Vila Real, Portugal; Department of Genetics and Biotechnology, University of Trás-os-Montes and Alto Douro, 5001-801 Vila Real, Portugal.
authors.forename: Gilberto
authors.initials: G
authors.lastname: Igrejas
authors.affiliation: Centre of Studies of Animal and Veterinary Sciences, University of Trás-os-Montes and Alto Douro, 5001-801 Vila Real, Portugal; Veterinary Science Department, University of Trás-os-Montes and Alto Douro, 5001-801 Vila Real, Portugal. Electronic address: ppoeta@utad.pt.
authors.forename: Patrícia
authors.initials: P
authors.lastname: Poeta
mesh_terms: D004352:Drug Resistance, Microbial; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology*; D006801:Humans; D011174:Portugal; D015995:Prevalence; D006435:Renal Dialysis; D065507:Vancomycin-Resistant Enterococci / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity; D014774:Virulence
keywords: Enterococos resistentes a la vancomicina; Haemodialysis; Hemodiálisis; Portugal; Vancomycin-resistant enterococci; vanA; vanA gene