title: Fosfomycin resistance among vancomycin-resistant enterococci owing to transfer of a plasmid harbouring the fosB gene.
abstract: The presence and characterisation of plasmid-mediated fosfomycin resistance determinants were investigated among 45 clinical vancomycin-resistant enterococci (VRE) isolated in Zhejiang Province, China. In total, 19 VRE were resistant to fosfomycin, of which 18 isolates had conjugative fosfomycin resistance and were positive for fosB. No reported fos genes were detected in the remaining isolate. Among the 18 fosB-carrying isolates, the fosB gene was always flanked by tnpA, suggesting the same novel fosB transposon. In 10 of the 18 fosB-carrying isolates, the fosB and tnpA genes were found reversely inserted in the vanA transposon Tn1546. In the remaining eight isolates the fosB and vanA genes were located on different plasmids. These findings indicate that acquisition of the conjugative plasmid harbouring the novel fosB transposon (ISL3-like transposon) and the Tn1546-like transposon (containing vanA and fosB) may explain, at least in part, the recent increase in fosfomycin-resistant Enterococcus faecium in China.
authors.affiliation: State Key Laboratory for Diagnosis and Treatment of Infectious Disease, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
authors.forename: Ting-ting
authors.initials: TT
authors.lastname: Qu
authors.affiliation: Department of Infectious Diseases, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
authors.forename: Ke-ren
authors.initials: KR
authors.lastname: Shi
authors.affiliation: Department of Infectious Diseases, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
authors.forename: Jing-shu
authors.initials: JS
authors.lastname: Ji
authors.affiliation: State Key Laboratory for Diagnosis and Treatment of Infectious Disease, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Yang
authors.affiliation: Department of Infectious Diseases, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
authors.forename: Xiao-xing
authors.initials: XX
authors.lastname: Du
authors.affiliation: State Key Laboratory for Diagnosis and Treatment of Infectious Disease, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
authors.forename: Ze-qing
authors.initials: ZQ
authors.lastname: Wei
authors.affiliation: State Key Laboratory for Diagnosis and Treatment of Infectious Disease, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China; Department of Infectious Diseases, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China. Electronic address: yvys119@163.com.
authors.forename: Yun-song
authors.initials: YS
authors.lastname: Yu
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics; D019729:Carbon-Oxygen Ligases / Q000235:genetics; D003227:Conjugation, Genetic; D004251:DNA Transposable Elements; D024881:Drug Resistance, Bacterial / Q000235:genetics; D016983:Enterococcus / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D005578:Fosfomycin / Q000494:pharmacology*; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy; D006801:Humans; D008826:Microbial Sensitivity Tests; D058885:Multilocus Sequence Typing; D010957:Plasmids / Q000187:drug effects / Q000235:genetics*; D016760:Proto-Oncogene Proteins c-fos / Q000235:genetics*; D019895:Transposases / Q000235:genetics; D014640:Vancomycin / Q000494:pharmacology; D020713:Vancomycin Resistance / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D004251:DNA Transposable Elements; D016760:Proto-Oncogene Proteins c-fos; C071437:VanA ligase, Bacteria; D005578:Fosfomycin; D014640:Vancomycin; D019895:Transposases; D019729:Carbon-Oxygen Ligases
keywords: Fosfomycin; Plasmid; Resistance; VRE; Vancomycin-resistant enterococci; fosB