Jozefíková Anna, Valček Adam, Šoltys Katarína, Nováková Elena, Bujdáková Helena
Department of Microbiology and Virology, Faculty of Natural Sciences, Comenius University in Bratislava, Slovakia.
Department of Microbiology and Virology, Faculty of Natural Sciences, Comenius University in Bratislava, Slovakia; Microbial Resistance and Drug Discovery, VIB-VUB Center for Structural Biology, VIB, Flanders Institute for Biotechnology, Brussels, Belgium; Structural Biology Brussels, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
Int J Antimicrob Agents. 2022 Apr;59(4):106561. doi: 10.1016/j.ijantimicag.2022.106561. Epub 2022 Mar 8.
Hospital vancomycin-resistant Enterococcus faecium (VREfm) were evaluated in term of resistance and phylogenetic relatedness to estimate the location and possible route of transmission of resistance determinants.
Hospital VREfm (n = 49) were collected in the northern part of Slovakia during 2017-2020. The collection was analysed for the presence of the van operon and 10 representatives were subjected to whole-genome sequencing using Illumina MiSeq platform. Obtained sequences were de novo assembled and the draft genome assemblies were analysed with respect to sequence type (ST), plasmid content, resistance and virulence genes, and the phylogenetic relatedness in single nucleotide polymorphisms (SNP).
All strains possessed the vanA operon. Ten selected evaluated isolates belonged to the clinically relevant clonal complex (CC) 17 and carried the vanHAX gene cluster conferring vancomycin resistance on mobile genetic elements, except for the isolate M17773 carrying the vanHAX gene cluster chromosomally. All isolates encoded resistance to quinolones (gyrA and parC mutations) and aminoglycosides [aac(6')-aph(2'')]. Four isolates from different wards and patients belonging to ST17 were closely related (6-50 SNP), suggesting long-term persistence of VREfm ST17 in hospital settings.
VREfm proved to harbour many genetic determinants of antimicrobial resistance. The plasmids carrying the vanA genes belonged to the conjugative broad-host families Inc18 and RepA_N, posing a threat to human health, especially in hospital settings. Moreover, four clinical isolates were phylogenetically related, pointing towards stable circulation of the ST17 VREfm clone in the hospital setting and underlining the necessity for continuous surveillance of glycopeptide-resistant pathogens.
对医院内耐万古霉素屎肠球菌（VREfm）的耐药性及系统发育相关性进行评估，以推测耐药决定簇的位置及可能的传播途径。
2017 - 2020年期间在斯洛伐克北部收集医院VREfm菌株（n = 49）。分析这些菌株中van操纵子的存在情况，并使用Illumina MiSeq平台对10株代表性菌株进行全基因组测序。对获得的序列进行从头组装，并从序列类型（ST）、质粒含量、耐药和毒力基因以及单核苷酸多态性（SNP）方面的系统发育相关性对基因组草图组装进行分析。
所有菌株均具有vanA操纵子。除了染色体携带vanHAX基因簇的菌株M17773外，10株选定评估的分离株属于临床相关的克隆复合体（CC）17，并在移动遗传元件上携带赋予万古霉素耐药性的vanHAX基因簇。所有分离株均编码对喹诺酮类（gyrA和parC突变）和氨基糖苷类[aac(6')-aph(2'')]的耐药性。来自不同病房和患者的4株属于ST17的分离株密切相关（6 - 50个SNP），表明VREfm ST17在医院环境中长期存在。
VREfm被证明含有许多抗菌药物耐药的遗传决定簇。携带vanA基因的质粒属于接合性广宿主家族Inc18和RepA_N，对人类健康构成威胁，尤其是在医院环境中。此外，4株临床分离株在系统发育上相关，表明ST17 VREfm克隆在医院环境中稳定传播，并强调了持续监测糖肽类耐药病原体的必要性。
