title: Multidrug-resistant enterococci in the hospital environment: detection of novel vancomycin-resistant E. faecium clone ST910.
abstract: BACKGROUND
  The role of the hospital environment as a reservoir of resistant bacteria in Tunisia has been poorly investigated; however, it could be responsible for the transmission of multidrug-resistant bacteria. The objective was to study the prevalence of Enterococcus in the environment of a Tunisian hospital and the antibiotic resistance phenotype/genotype in recovered isolates, with special reference to vancomycin resistance.
  
  
  METHODS
  A total of 300 samples were taken (March-June, 2013) and inoculated in Slanetz-Bartley agar plates supplemented or not supplemented with 8 µg/mL of vancomycin. Antibiotic resistance genes were tested by polymerase chain reaction (PCR). The clonal relatedness of the vanA isolates was assessed using pulsed-field gel electrophoresis (PFGE) and multilocus sequence testing (MLST).
  
  
  RESULTS
  Enterococci were recovered in 33.3% of tested samples inoculated in SB medium. E faecium was the most prevalent species, followed by E. faecalis and E. casseliflavus. Antimicrobial resistance genes detected were as follows (number of isolates): erm(B) (71), tet(M) (18), aph(3')-IIIa (27), ant(6)-Ia (15), cat(A) (4), and van(C2) (6). Vancomycin-resistant-enterococci (VRE) were recovered from 14 samples (4.7%), when tested in SB-VAN. The 14 VRE (one per positive sample) were identified as E. faecium and contained the van(A),erm(B), tet(M), ant(6)-Ia, and aph(3')-IIIa genes. Thirteen of the VRE strains were ascribed by PFGE and MLST to a novel clone (new ST910), and only one VRE strain was typed as ST80 included in CC17.
  
  
  CONCLUSIONS
  The emergence and spread of new clones of VRE, especially in the hospital environment in this country, could become particularly problematic.
authors: Faculty of Sciences of Tunis, University of Tunis El Manar, Tunis, Tunisia. rawdha_dziri@hotmail.com.
authors: Raoudha
authors: R
authors: Dziri
authors: Carmen
authors: C
authors: Lozano
authors: Leila
authors: L
authors: Ben Said
authors: Ridha
authors: R
authors: Bellaaj
authors: Abdellatif
authors: A
authors: Boudabous
authors: Karim
authors: K
authors: Ben Slama
authors: Carmen
authors: C
authors: Torres
authors: Naouel
authors: N
authors: Klibi
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D004269:DNA, Bacterial / Q000235:genetics; D024901:Drug Resistance, Multiple, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D004783:Environmental Microbiology; D005838:Genotype; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology / Q000382:microbiology*; D006761:Hospitals; D006801:Humans; D017720:Molecular Epidemiology; D058885:Multilocus Sequence Typing; D010641:Phenotype; D016133:Polymerase Chain Reaction; D015995:Prevalence; D014416:Tunisia / Q000453:epidemiology; D065507:Vancomycin-Resistant Enterococci / Q000145:classification* / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial