Valdezate Sylvia, Labayru Cristina, Navarro Ana, Mantecón María A, Ortega María, Coque Teresa M, García Moisés, Saéz-Nieto Juan A
Departamento de Bacteriología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
J Antimicrob Chemother. 2009 Jan;63(1):17-20. doi: 10.1093/jac/dkn449. Epub 2008 Nov 11.
A large clonal outbreak of multidrug-resistant CC17 ST17 Enterococcus faecium containing Tn5382 in a hospital in the north of Spain is described.
We characterized vancomycin-resistant E. faecium isolates from 10 infected and 40 colonized inpatients from a single hospital by PFGE, multiple-locus variable-number tandem-repeat analysis (MLVA) and multilocus sequence typing (MLST). Genes encoding antibiotic resistance (ampicillin, aminoglycosides, macrolides, quinupristin/dalfopristin, quinolones, tetracycline) and putative virulence traits were analysed.
All isolates showed highly similar PFGE profiles and were assigned to the type MT1 by MLVA and to ST17 (CC17) by MLST. The Tn5382 type identified in all isolates was linked to pbp5 and contained a 5 bp deletion and 10 point mutations within the intergenic vanS(B)-vanY(B) region. Other resistance genes identified were erm(B), mef(E), tet(M), ant(6')-Ia, aph(3')-IIIa and aac(6')-Ie-aph(2'')-Ia. All isolates carried the unexpressed tet(M) gene. The high level of ciprofloxacin resistance was attributable to the first described Gly-61 and Ile-80 mutations in ParC and the Tyr-83 or Arg-83 mutations in GyrA. All isolates contained esp. The presence of hyl was variable.
A large clonal outbreak caused by multidrug-resistant CC17 E. faecium containing pbp5-Tn5382 is described. The persistence of this clone, which has been recovered from both hospital and community settings since 2005, and the possibility of transferring this Tn5382 to other epidemic ampicillin-resistant clonal types currently circulating in Spain might contribute to increasing the prevalence of vancomycin-resistant enterococci in our area. This study constitutes the first description of mef(E) in E. faecium.
描述了西班牙北部一家医院中含有Tn5382的多重耐药CC17 ST17粪肠球菌的大规模克隆暴发。
我们通过脉冲场凝胶电泳（PFGE）、多位点可变数目串联重复分析（MLVA）和多位点序列分型（MLST）对来自同一家医院的10例感染和40例定植住院患者的耐万古霉素粪肠球菌分离株进行了特征分析。分析了编码抗生素耐药性（氨苄西林、氨基糖苷类、大环内酯类、奎奴普丁/达福普汀、喹诺酮类、四环素）和假定毒力特征的基因。
所有分离株显示出高度相似的PFGE图谱，通过MLVA被归为MT1型，通过MLST被归为ST17（CC17）型。在所有分离株中鉴定出的Tn5382类型与pbp5相关，并且在基因间vanS(B)-vanY(B)区域内包含一个5 bp的缺失和10个点突变。鉴定出的其他耐药基因有erm(B)、mef(E)、tet(M)、ant(6')-Ia、aph(3')-IIIa和aac(6')-Ie-aph(2'')-Ia。所有分离株都携带未表达的tet(M)基因。对环丙沙星的高耐药水平归因于首次描述的ParC中Gly-61和Ile-80突变以及GyrA中Tyr-83或Arg-83突变。所有分离株都含有esp。hyl的存在情况各不相同。
描述了由含有pbp5-Tn5382的多重耐药CC17粪肠球菌引起的大规模克隆暴发。自2005年以来，该克隆在医院和社区环境中均有发现，其持续存在以及将这种Tn5382转移到目前在西班牙流行的其他耐氨苄西林克隆类型的可能性，可能会导致我们地区耐万古霉素肠球菌的患病率增加。本研究首次描述了粪肠球菌中的mef(E)。
