title: Molecular characterization of vancomycin-resistant enterococci in Serbia: intensive care unit as the source.
abstract: The purpose of this study was to evaluate the molecular relatedness of clinical isolates of vancomycin-resistant enterococci (VRE) collected from patients of the Clinic for Infectious and Tropical Diseases in Belgrade. Among 40 isolates available for the investigation, 36 were identified as Enterococcus faecium, whereas 2 were Enterococcus faecalis and Enterococcus raffinosus, respectively. Pulsed-field gel electrophoresis (PFGE) typing revealed 21 strain types, comprising 7 clusters which contained at least two isolates and 14 unique PFGE patterns. Although we searched for pathogenicity factor genes (gelE, cylB, asa1, efaAfs, esp, cpd, cob) in representatives of all macro-restriction patterns, they have been confirmed in only one clone of E. faecalis. Genes esp and hyl, commonly found in E. faecium, were yilded in 10 macro-restriction patterns of this species, and their presence could not be ascribed to clonally related strains (p = 0.05). All VRE isolates were multiresistant and positive for vanA gene. Twenty strains of VRE and 6 clusters obtained from Intensive care unit (ICU) are proof of intensive transmission of these microorganisms at this department. The results of this study suggest wide genotypic variability among the clinical VRE isolates, but also intrahospital dissemination of some of them.
authors.affiliation: Department of Microbiology of Clinical Center of Serbia Belgrade Serbia.
authors.forename: Milica
authors.initials: M
authors.lastname: Jovanović
authors.forename: Branko
authors.initials: B
authors.lastname: Milošević
authors.forename: Olga
authors.initials: O
authors.lastname: Dulović
authors.forename: Mijomir
authors.initials: M
authors.lastname: Pelemiš
authors.forename: Goran
authors.initials: G
authors.lastname: Stevanović
authors.forename: Tanja
authors.initials: T
authors.lastname: Tošić
authors.forename: Branka
authors.initials: B
authors.lastname: Stošović
authors.forename: M J
authors.initials: MJ
authors.lastname: Zervos
mesh_terms: D016521:Electrophoresis, Gel, Pulsed-Field; D016983:Enterococcus / Q000187:drug effects* / Q000235:genetics; D007362:Intensive Care Units; D055771:Serbia; D020713:Vancomycin Resistance
keywords: Enterococcus faecium; intensive care unit; vancomycin resistant enterococci