title: Genotyping of clinical and environmental multidrug resistantEnterococcus faeciumstrains.
abstract: BACKGROUND
  Multidrug resistant (MDR) Enterococcus faecium is a nosocomial pathogen and clonal complex 17 (CC17) is the main genetic subpopulation of E. faecium in hospitals worldwide.
  
  
  OBJECTIVE
  There has thus far been no report of major E. faecium clones in Iranian hospitals.
  
  
  METHODS
  The present study analyzed strains of MDR E. faecium obtained from patients and the Intensive Care Unit environments using pulsed field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) to determine the antibiotic resistance patterns and genetic features of the dominant.
  
  
  RESULTS
  clones of E. faecium. PFGE and MLST analysis revealed the presence of 17and 15 different subtypes, respectively. Of these, 18 (86%) isolates belonged toCC17. Most strains in this clonal complex harbored the esp gene and exhibited resistance to vancomycin, teicoplanin, ampicillin, ciprofloxacin, gentamicin, and erythromycin. The MLST results revealed 12 new sequence types (ST) for the first time. Approximately 50% of the STs were associated with ST203.
  
  
  CONCLUSIONS
  Detection of E. faecium strains belonging to CC17 on medical equipment and in clinical specimens verified the circulation of high-risk MDR clones among the patients and in hospital environments in Iran.
authors.affiliation: Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
authors.forename: Leili
authors.initials: L
authors.lastname: Shokoohizadeh
authors.affiliation: Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
authors.forename: Ashraf Mohabati
authors.initials: AM
authors.lastname: Mobarez
authors.affiliation: Research Center of Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Alebouyeh
authors.affiliation: Research Center of Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Zali
authors.affiliation: Molecular Biology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Ranjbar
mesh_terms: D003428:Cross Infection / Q000382:microbiology*; D024901:Drug Resistance, Multiple, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D016984:Enterococcus faecium / Q000145:classification* / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D004783:Environmental Microbiology; D014644:Genetic Variation; D005838:Genotype; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology*; D006761:Hospitals; D006801:Humans; D007362:Intensive Care Units; D007492:Iran; D058885:Multilocus Sequence Typing