Willems R J, Homan W, Top J, van Santen-Verheuvel M, Tribe D, Manzioros X, Gaillard C, Vandenbroucke-Grauls C M, Mascini E M, van Kregten E, van Embden J D, Bonten M J
Lancet. 2001 Mar 17;357(9259):853-5. doi: 10.1016/S0140-6736(00)04205-7.
In the USA, vancomycin-resistant Enterococcus faecium (VREF) is endemic in hospitals, despite lack of carriage among healthy individuals. In Europe, however, hospital outbreaks are rare, but VREF carriage among healthy individuals and livestock is common. We used amplified fragment-length polymorphism analysis to genotype 120 VREF isolates associated with hospital outbreaks and 45 non-epidemic isolates from the USA, Europe, and Australia. We also looked for the esp virulence gene in these isolates and in 98 VREF from animals. A specific E. faecium subpopulation genetically distinct from non-epidemic VREF isolates was found to be the cause of the hospital epidemics in all three continents. This subpopulation contained a variant of the esp gene that was absent in all non-epidemic and animal isolates. Identification of the variant esp gene will be important in guiding infection-control strategies, and the Esp protein could be a new target for antibacterial therapy.
在美国，耐万古霉素屎肠球菌（VREF）在医院中呈地方性流行，尽管健康个体中不存在携带情况。然而，在欧洲，医院暴发很少见，但健康个体和家畜中VREF携带情况很常见。我们使用扩增片段长度多态性分析对来自美国、欧洲和澳大利亚的120株与医院暴发相关的VREF分离株和45株非流行分离株进行基因分型。我们还在这些分离株以及98株来自动物的VREF中寻找esp毒力基因。发现一个在遗传上与非流行VREF分离株不同的特定屎肠球菌亚群是三大洲医院疫情的病因。该亚群含有esp基因的一个变体，所有非流行和动物分离株中均不存在该变体。鉴定该变体esp基因对于指导感染控制策略很重要，并且Esp蛋白可能成为抗菌治疗的新靶点。
