Phenotypic and genotypic characterization of vancomycin-resistant Enterococcus faecium clinical isolates from two hospitals in Mexico: First detection of VanB phenotype-vanA genotype

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• 作者：Paola Bocanegra-Ibarias<sup>asup><sup> ; sup><sup>&loz ; sup> ; Samantha Flores-Treviñ ; o<sup>asup><sup> ; sup><sup>&loz ; sup> ; Adriá ; n Camacho-Ortiz<sup>bsup> ; Rayo Morfin-Otero<sup>csup> ; Licet Villarreal-Treviñ ; o<sup>dsup> ; Jorge Llaca-Dí ; az<sup>esup> ; Erik Alan Martí ; nez-Landeros<sup>bsup> ; Eduardo Rodrí ; guez-Noriega<sup>csup> ; André ; s Calzada-Gü ; ereca<sup>dsup> ; Hé ; ctor Jesú ; s Maldonado-Garza<sup>asup> ; Elvira Garza-Gonzá ; lez<sup>asup><sup> ; sup><sup>esup><sup> ; sup><sup>elvira_garza_gzz@yahoo.com" class="auth_mail" title="E-mail the corresponding authorsup>
• 关键词：Vancomycin resistance ; Enterococcus faecium ; Mexico ; Clonal diversity ; VanB phenotype-vanA genotype
• 刊名：Enfermedades Infecciosas y Microbiología Clínica
• 出版年：2016
• 出版时间：August-September 2016
• 年：2016
• 卷：34
• 期：7
• 页码：415-421
• 全文大小：781 K

文摘

Enterococcus faecium has emerged as a multidrug-resistant nosocomial pathogen involved in outbreaks worldwide. Our aim was to determine the antimicrobial susceptibility, biofilm production, and clonal relatedness of vancomycin-resistant E. faecium (VREF) clinical isolates from two hospitals in Mexico.

sSec_2">Methods

spar0010">Consecutive clinical isolates (n = 56) were collected in two tertiary care hospitals in Mexico from 2011 to 2014. VREF isolates were characterized by phenotypic and molecular methods including pulsed-field gel electrophoresis (PFGE).

sSec_3">Results

spar0015">VREF isolates were highly resistant to vancomycin, erythromycin, norfloxacin, high-level streptomycin, and teicoplanin, and showed lower resistance to tetracycline, nitrofurantoin and quinupristin-dalfopristin. None of the isolates were resistant to linezolid. The vanA gene was detected in all isolates. Two VanB phenotype-vanA genotype isolates, highly resistant to vancomycin and susceptible to teicoplanin, were detected. Furthermore, 17.9% of the isolates were classified as biofilm producers, and the espfm gene was found in 98.2% of the isolates. A total of 37 distinct PFGE patterns and 6 clones (25% of the isolates as clone A, 5.4% as clone B, and 3.6% each as clone C, D, E, and F) were detected. Clone A was detected in 5 different wards of the same hospital during 14 months of surveillance.

sSec_4">Conclusion

spar0020">The high resistance to most antimicrobial agents and the moderate cross-transmission of VREF detected accentuates the need for continuous surveillance of E. faecium in the hospital setting. This is also the first reported incidence of the E. faecium VanB phenotype-vanA genotype in the Americas.