title: Invasive enterococcal infections in Poland: the current epidemiological situation.
abstract: The aim of this study was to investigate human invasive isolates of enterococci, obtained through prospective surveillance in Poland. The consecutive enterococcal isolates were collected in 30 hospitals between May 2010 and June 2011, and studied by species identification, antimicrobial susceptibility testing and, for Enterococcus faecium by detection of markers specific for the hospital meroclone, multilocus VNTR analysis (MLVA) and multilocus sequence typing (MLST). Additionally, the genomic difference regions (GDRs) characteristic for lineage 78 were searched by PCR. Among 259 isolates, a nearly equal number of Enterococcus faecalis (n = 140; 54.1 %) and E. faecium (n = 112; 43.2 %) was found. The observed 14-day mortality rate of infected patients reached 18.1 %. All isolates were susceptible to linezolid and daptomycin. High-level aminoglycoside resistance occurred in over 50 % of isolates. Vancomycin resistance mediated by vanA or vanB was detected in 7.1 % of E. faecium; 71.4 % of isolates were multidrug resistant. E. faecium isolates ubiquitously carried molecular markers of hospital-associated meroclone (IS16, esp(Efm), intA of ICEEfm1) and multilocus sequence typing showed the domination of representatives of lineages 78 and 17/18 (52.7 % and 46.4 %, respectively). Isolates of lineage 78 were significantly enriched in all the GDRs studied. The recent spread of E. faecium from this lineage contributed to the observed increase of E. faecium in enterococcal invasive infections in hospitals in Poland.
authors.affiliation: Department of Molecular Microbiology, National Medicines Institute, ul. Chełmska 30/34, 00-725, Warsaw, Poland.
authors.forename: I
authors.initials: I
authors.lastname: Gawryszewska
authors.affiliation: Department of Epidemiology and Clinical Microbiology, National Medicines Institute, ul. Chełmska 30/34, 00-725, Warsaw, Poland. dzabicka@cls.edu.pl.
authors.forename: D
authors.initials: D
authors.lastname: Żabicka
authors.affiliation: Department of Epidemiology and Clinical Microbiology, National Medicines Institute, ul. Chełmska 30/34, 00-725, Warsaw, Poland.
authors.forename: K
authors.initials: K
authors.lastname: Bojarska
authors.affiliation: Department of Epidemiology and Clinical Microbiology, National Medicines Institute, ul. Chełmska 30/34, 00-725, Warsaw, Poland.
authors.forename: K
authors.initials: K
authors.lastname: Malinowska
authors.affiliation: Department of Epidemiology and Clinical Microbiology, National Medicines Institute, ul. Chełmska 30/34, 00-725, Warsaw, Poland.
authors.forename: W
authors.initials: W
authors.lastname: Hryniewicz
authors.affiliation: Department of Molecular Microbiology, National Medicines Institute, ul. Chełmska 30/34, 00-725, Warsaw, Poland.
authors.forename: E
authors.initials: E
authors.lastname: Sadowy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D018441:Biofilms; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection; D016983:Enterococcus / Q000145:classification* / Q000187:drug effects / Q000235:genetics; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D058889:Molecular Typing; D058885:Multilocus Sequence Typing; D063868:Patient Outcome Assessment; D011044:Poland / Q000453:epidemiology; D011159:Population Surveillance; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents