title: Novel type of VanB2 teicoplanin-resistant hospital-associated Enterococcus faecium.
abstract: Seven high-risk clones of vancomycin-resistant Enterococcus faecium (VREF) belonging to clonal complex 17 were identified using multilocus sequence typing (MLST) among clinical isolates from Saudi Arabia. Among these isolates, a new hospital-associated sequence type (ST795), VanB(2)-type teicoplanin-resistant strain was detected. Its unusual phenotype resulted from a new combination of mutations in the ddl, vanS and vanW genes, which confirmed the trend of evolution in VanB-type resistance. Furthermore, characteristics of adaptation and persistence in the hospital environment of ST795 were emphasised by the presence of genes and clusters recognised to be specific for hospital-associated VREF.
authors: Dipartimento di Scienze Biomediche, Università di Sassari, Viale San Pietro 43/b, 07100 Sassari, Italy.
authors: Antonella
authors: A
authors: Santona
authors: Dipartimento di Scienze Biomediche, Università di Sassari, Viale San Pietro 43/b, 07100 Sassari, Italy.
authors: Bianca
authors: B
authors: Paglietti
authors: Department of Infection and Immunity, King Faisal Specialist Hospital and Research Centre, P.O. Box 3354 (MBC-03), Riyadh 11211, Saudi Arabia; Liver Disease Research Centre, King Saud University, Riyadh, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
authors: Ahmed A
authors: AA
authors: Al-Qahtani
authors: Department of Infection and Immunity, King Faisal Specialist Hospital and Research Centre, P.O. Box 3354 (MBC-03), Riyadh 11211, Saudi Arabia.
authors: Marie Fe F
authors: MF
authors: Bohol
authors: College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
authors: Abiola
authors: A
authors: Senok
authors: Dipartimento di Scienze Biomediche, Università di Sassari, Viale San Pietro 43/b, 07100 Sassari, Italy.
authors: Massimo
authors: M
authors: Deligios
authors: Dipartimento di Scienze Biomediche, Università di Sassari, Viale San Pietro 43/b, 07100 Sassari, Italy; Department of Infection and Immunity, King Faisal Specialist Hospital and Research Centre, P.O. Box 3354 (MBC-03), Riyadh 11211, Saudi Arabia.
authors: Salvatore
authors: S
authors: Rubino
authors: Dipartimento di Scienze Biomediche, Università di Sassari, Viale San Pietro 43/b, 07100 Sassari, Italy; Department of Infection and Immunity, King Faisal Specialist Hospital and Research Centre, P.O. Box 3354 (MBC-03), Riyadh 11211, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia. Electronic address: ahdal@kfshrc.edu.sa.
authors: Mohammed N
authors: MN
authors: Al-Ahdal
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics*; D016000:Cluster Analysis; D003428:Cross Infection / Q000382:microbiology; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D024881:Drug Resistance, Bacterial; D016984:Enterococcus faecium / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D005838:Genotype; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology*; D006801:Humans; D008969:Molecular Sequence Data; D058885:Multilocus Sequence Typing; D009154:Mutation; D012529:Saudi Arabia; D017422:Sequence Analysis, DNA; D017334:Teicoplanin / Q000494:pharmacology*; D065507:Vancomycin-Resistant Enterococci / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D004269:DNA, Bacterial; C079913:VanB protein, Enterococcus; D017334:Teicoplanin
keywords: Enterococcus faecium; Hospital-associated; MLST; Teicoplanin resistance mechanism