Free Content Clonal heterogeneity of clinical isolates of vancomycin-resistant Enterococcus faecium with unique vanS

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Abstract:

Summary Objective  To examine the clonal diversity of vancomycin-resistant enterococci (VRE). Methods  A total of 900 clinical isolates of enterococci were obtained, and VRE isolates were subjected to antimicrobial susceptibility tests, biochemical fingerprinting with the PhPlate system (PhP), ribotyping and pulsed-field gel electrophoresis (PFGE) typing. Results  Forty-nine of all enterococcal isolates were resistant to high levels of vancomycin (MIC ≥ 128) and identified as . Biochemical fingerprinting with PhP showed that the VRE isolates were highly diverse (diversity index,  = 0.93) and belonged to 24 PhP-types. The VRE could be separated into 34 and 27 types with PFGE and ribotyping, giving diversity indices of 0.98 and 0.97, respectively. The PFGE method was more discriminatory than ribotyping and PhP system for isolates. A combination of either of the two typing methods resulted in at least 44 types. Furthermore, sequencing analysis of of Tn showed one nucleotide mutation (C→A) at position 5727 in comparison with the prototype BM4147, which was found to be unique in all Iranian VRE isolates. Conclusion  The isolated clinical VRE strains were highly diverse in Tehran.

French
Objectif 

Examiner la diversité clonale des entérocoques résistants à la vancomycine (ERV). Méthodes 

Un total de 900 isolats cliniques d’entérocoques a été obtenu et les isolats ERV ont été soumis à des tests de sensibilité aux antimicrobiens, au typage biochimique avec le système PhPlate (PhP) et au ribotypage par la méthode du Pulse Field Gel Electrophoresis (PFGE). Résultats 

49 de tous les isolats d’entérocoques étaient résistants avec des niveaux de résistance élevés pour la vancomycine (CMI ≥ 128) et étaient identifiés comme Enterococcus faecium. Le typage biochimiques avec le PhP a révélé que les isolats ERV étaient très divers (Di = 0,93) et appartenaient à 24 types PhP. Les ERV pourraient être classifiés en 34 et 27 types par le PFGE et le ribotypage, donnant des indices de diversité de 0,98 et 0,97, respectivement. La méthode du PFGE est plus discriminative que le ribotypage et le système PhP pour les isolats de E. faecium. La combinaison de deux des méthodes de typage mène à au moins 44 types. En outre, l’analyse du séquençage de vanS de Tn1546 a révélé une mutation nucléotidique (C → A), à la position 5727 en comparaison avec le prototype BM4174, qui s’est avéréêtre unique dans tous les isolats iraniens ERV. Conclusion 

Les isolats cliniques ERV sont très diversifiés à Téhéran.

Keywords: E. faecium; Enterococcus faecium; PFGE; antibiotics; antibiotiques; antibióticos; ribotipaje; ribotypage; ribotyping

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1365-3156.2008.02065.x

Affiliations: 1:  Department of Microbiology, Pasteur Institute of Iran, Tehran, Iran 2:  Faculty of Science, Health and Education, University of the Sunshine Coast, QLD, Australia 3:  Department of Bacteriology, School of Public Health, Tehran Medical University, Tehran, Iran 4:  Microbiology, Tumor and Cell Biology Centre, Karolinska Institute, Stockholm, Sweden

Publication date: May 1, 2008

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