title: Prevalence of Diverse Clones of Vancomycin-Resistant Enterococcus faecium ST78 in a Chinese Hospital.
abstract: BACKGROUND
  Vancomycin-resistant Enterococcus (VRE) has been identified in China. However, little is known about the spread of VRE isolates.
  
  
  METHODS
  The genetic relatedness of vancomycin-resistant Enterococcus faecium (VREfm) isolates was analyzed by pulsed-field gel electrophoresis (PFGE), their antimicrobial susceptibilities were analyzed by E-test and the VITEK 2 AST-GP67 test Kit, and their sequence types (STs) were investigated by multilocus sequence typing (MLST). S1-PFGE was used for plasmid profiling, and PCR and subsequent sequencing were performed to identify the virulence genes.
  
  
  RESULTS
  A total of 96 nonduplicated VREfm isolates were obtained and categorized into 38 PFGE types (type 1-38). The predominant MLST type was ST78, while ST17, ST341, and ST342 were also sporadically identified. All types of clinical VREfm strains harbored the vanA gene; however, they carried plasmids of different sizes. While 92.1%, 71.1%, and 60.5% of VREfm strains carried hyl, scm, and ecbA genes, respectively, all of them were positive for esp, acm, sgrA, pilA, and pilB genes.
  
  
  CONCLUSIONS
  Clonal VREfm spread was observed, and nonplasmid-mediated horizontal transfer of vancomycin-resistant gene might have conveyed resistance to some vancomycin-susceptible E. faecium strains. E. faecium ST78 carrying vanA gene was the most prevalent clone in this study. The high prevalence of virulence genes, including esp, hyl, acm, scm, ecbA, sgrA, pilA, and pilB, confirmed their important roles in the emergence of VREfm ST78 in nosocomial infections.
authors.affiliation: 1 Department of Microbiology, Chinese PLA General Hospital , Beijing, China .
authors.forename: Jiyong
authors.initials: J
authors.lastname: Yang
authors.affiliation: 2 Wound Healing Unit, Trauma Center of Postgraduate Medical School , Chinese PLA General Hospital, Beijing, China .
authors.forename: Yufeng
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: 1 Department of Microbiology, Chinese PLA General Hospital , Beijing, China .
authors.forename: Ling
authors.initials: L
authors.lastname: Guo
authors.affiliation: 1 Department of Microbiology, Chinese PLA General Hospital , Beijing, China .
authors.forename: LIyan
authors.initials: L
authors.lastname: Ye
authors.affiliation: 1 Department of Microbiology, Chinese PLA General Hospital , Beijing, China .
authors.forename: Yanning
authors.initials: Y
authors.lastname: Ma
authors.affiliation: 1 Department of Microbiology, Chinese PLA General Hospital , Beijing, China .
authors.forename: Yanping
authors.initials: Y
authors.lastname: Luo
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics*; D015373:Bacterial Typing Techniques; D019729:Carbon-Oxygen Ligases / Q000235:genetics*; D002681:China / Q000453:epidemiology; D002999:Clone Cells; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D016521:Electrophoresis, Gel, Pulsed-Field; D016984:Enterococcus faecium / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification / Q000472:pathogenicity; D005260:Female; D015870:Gene Expression; D022761:Gene Transfer, Horizontal; D005838:Genotype; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D006761:Hospitals; D006801:Humans; D008297:Male; D010957:Plasmids / Q000737:chemistry / Q000378:metabolism; D015995:Prevalence; D017422:Sequence Analysis, DNA; D014640:Vancomycin / Q000494:pharmacology; D065507:Vancomycin-Resistant Enterococci / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification / Q000472:pathogenicity; D037521:Virulence Factors / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; C071437:VanA ligase, Bacteria; D037521:Virulence Factors; D014640:Vancomycin; D019729:Carbon-Oxygen Ligases