title: vanA-positive multi-drug-resistant Enterococcus spp. isolated from surfaces of a US hospital laundry facility.
abstract: BACKGROUND
  Enterococcus spp. are a normal part of the gastrointestinal tract of humans and animals. They are also important pathogens, being responsible for 14% of US nosocomial infections from 2007 to 2010.
  
  
  OBJECTIVE
  To examine a laundry facility that processes clinical linens for the presence and seasonality of vancomycin-resistant Enterococcus spp.
  
  
  METHODS
  Surface samples were collected four times in 2015 from the dirty and clean areas of the laundry facility. Isolates were confirmed using biochemical assays, and antibiotic susceptibility testing was performed. Further investigations included molecular characterization by multi-locus sequence typing (MLST), detection of acquired vanA and vanB and/or intrinsic vanC1 genes by polymerase chain reaction, and eBURST analysis.
  
  
  RESULTS
  Seventy-four vanA-positive multi-drug-resistant Enterococcus spp. were identified: 64/120 (53%) in the dirty area and 10/120 (8%) in the clean area. There were 14 ST types among the E. faecium isolates identified (ST16, 17, 18, 117, 186, 280, 324, 412, 584, 664, 665, 736, 750 and 1038). Both E. faecalis isolates were ST109.
  
  
  CONCLUSIONS
  Isolation of vancomycin-resistant enterococci (VRE) isolates was significantly higher (53% vs 8%) in the dirty area of the facility compared with the clean area.
  
  
  CONCLUSIONS
  This is the first study to examine an industrial laundry facility for the presence of VRE, and may be an unrecognized reservoir.
authors.affiliation: Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA.
authors.forename: K E
authors.initials: KE
authors.lastname: Michael
authors.affiliation: Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA.
authors.forename: D
authors.initials: D
authors.lastname: No
authors.affiliation: Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA. Electronic address: marilynr@u.washington.edu.
authors.forename: M C
authors.initials: MC
authors.lastname: Roberts
mesh_terms: D001426:Bacterial Proteins / Q000235:genetics*; D001431:Bacteriological Techniques; D019729:Carbon-Oxygen Ligases / Q000235:genetics*; D024901:Drug Resistance, Multiple, Bacterial; D013293:Enterococcus faecalis / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D016984:Enterococcus faecium / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D004783:Environmental Microbiology; D006761:Hospitals; D006801:Humans; D007847:Laundry Service, Hospital; D058885:Multilocus Sequence Typing; D010453:Peptide Synthases / Q000235:genetics; D016133:Polymerase Chain Reaction; D015995:Prevalence; D014481:United States; D065507:Vancomycin-Resistant Enterococci / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*
chemical_list: D001426:Bacterial Proteins; C071437:VanA ligase, Bacteria; C079913:VanB protein, Enterococcus; D019729:Carbon-Oxygen Ligases; D010453:Peptide Synthases; C108395:VanC protein, Enterococcus
keywords: Enterococcus faecalis; Enterococcus faecium; Environmental contamination; Multi-locus sequence typing; Vancomycin-resistant enterococci; vanA