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Clustering of polyclonal VanB-type vancomycin-resistant Enterococcus faecium in a low-endemic area was associated with CC17-genogroup strains harbouring transferable vanB2-Tn5382 and pRUM-like repA containing plasmids with axe-txe plasmid addiction systems
Research Group for Host-Microbe Interactions, Department of Medical Biology, University of Tromsø, Tromsø, Norway.
Örebro University, School of Medical Sciences.
Research Group for Host-Microbe Interactions, Department of Medical Biology, University of Tromsø, Tromsø, Norway; Department of Microbiology and Infection Control, Reference Centre for Detection of Antimicrobial Resistance, University Hospital of North-Norway, Tromsø, Norway.
Department of Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.
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2011 (English)In: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 119, no 4-5, p. 247-258Article in journal (Refereed) Published
Abstract [en]

VanB-type vancomycin-resistant Enterococcus faecium isolates (n = 17) from 15 patients at the Örebro University hospital in Sweden during a span of 18 months was characterized. All patients had underlying disorders and received broad-spectrum antimicrobial therapy. Pulsed-field gel electrophoresis (PFGE) grouped 14 isolates in three PFGE types and three isolates in unique PFGE patterns. All isolates had multi-locus sequence types [ST17 (n = 5); ST18 (n = 3); ST125 (n = 7); ST262 (n = 1); ST460 (n = 1)] belonging to the successful hospital-adapted clonal complex 17 (CC17), harboured CC17-associated virulence genes, were vanB2-positive and expressed diverse vancomycin minimum inhibitory concentration (MICs; 8 to > 256 mg/L). Isolate 1 had a unique PFGE type and a chromosomal transferable vanB2-Tn5382 element. Interestingly, the other five PFGE types had Tn5382 located on plasmids containing pRUM-like repA and a plasmid addiction system (axe-txe) shown by co-hybridization analysis of PFGE-separated S1-nuclease digested total DNA. The resistance plasmids were mainly of 120-kb and supported intraspecies vanB transfer. Two strains were isolated from patient 6 and we observed a possible transfer of the vanB2-resistance genes from PFGE type III ST460 to a more successful PFGE type I ST125. This latter PFGE type I ST125 became the predominant type afterwards. Our observations support the notion that vanB-type vancomycin-resistant Enterococcus faecium can persist in a low-endemic area through successful clones and plasmids with stability functions in hospital patients with known risk factors.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2011. Vol. 119, no 4-5, p. 247-258
Keywords [en]
E; faecium; VRE; axetxe; CC17
National Category
Immunology in the medical area Microbiology in the medical area
Identifiers
URN: urn:nbn:se:oru:diva-25341DOI: 10.1111/j.1600-0463.2011.02724.xISI: 000289636600003PubMedID: 21492224Scopus ID: 2-s2.0-79954743999OAI: oai:DiVA.org:oru-25341DiVA, id: diva2:547080
Note

Funding Agencies:

Research Committee of Örebro County Council, Sweden  

Norwegian Research Council  165997  183653/S10 

Northern Norway Regional Health Authority  

European Commission  LSHE-CT-2007-03410 'ACE' 

Available from: 2012-08-27 Created: 2012-08-27 Last updated: 2018-02-19Bibliographically approved

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Rasmussen, GunlögSöderquist, Bo

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CiteExportLink to record
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