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Year : 2014  |  Volume : 32  |  Issue : 3  |  Page : 345--347

Commensal and environmental vancomycin-resistant Enterococcus faecium isolated in hospital settings: Genotypic diversity, antimicrobial resistance and virulence traits

LVP Gomes1, AT Morey1, JP Santos1, JD Cardoso2, CF Oliveira1, MRE Perugini3, LM Yamauchi1, SFY Ogatta1,  
1 Departamento de Microbiologia, Laboratório de Biologia Molecular de Microrganismos, Universidade Estadual de Londrina, PR, Brazil
2 Departamento de Microbiologia do Solo, Instituto Agronômico do Paraná, Londrina, PR, Brazil
3 Departamento de Patologia, Análises Clínicas e Toxicológicas, Laboratório de Microbiologia Clínica, Universidade Estadual de Londrina, PR, Brazil

Correspondence Address:
SFY Ogatta
Departamento de Microbiologia, Laboratório de Biologia Molecular de Microrganismos, Universidade Estadual de Londrina, PR
Brazil

How to cite this article:
Gomes L, Morey A T, Santos J P, Cardoso J D, Oliveira C F, Perugini M, Yamauchi L M, Ogatta S. Commensal and environmental vancomycin-resistant Enterococcus faecium isolated in hospital settings: Genotypic diversity, antimicrobial resistance and virulence traits.Indian J Med Microbiol 2014;32:345-347

How to cite this URL:
Gomes L, Morey A T, Santos J P, Cardoso J D, Oliveira C F, Perugini M, Yamauchi L M, Ogatta S. Commensal and environmental vancomycin-resistant Enterococcus faecium isolated in hospital settings: Genotypic diversity, antimicrobial resistance and virulence traits. Indian J Med Microbiol [serial online] 2014 [cited 2019 Oct 15 ];32:345-347
Available from: http://www.ijmm.org/text.asp?2014/32/3/345/136603

Full Text

Dear Editor,

At the University Hospital of Londrina, Paranα, Brazil, cultures of stools are examined weekly for all patients housed in intensive care units and for all patients found to be colonised or infected with vancomycin-resistant enterococci (VRE), as part of the hospital surveillance study for multidrug-resistant microorganisms. A total of 24 non-duplicates vancomycin-resistant Enterococcus faecium (VREfm) isolated in this hospital during 2009 and 2010 were included in this study. Fourteen isolates were recovered from stool cultures of rectal swab specimens. All patients were adults and the underlying clinical conditions at admission were as follows: stroke (6/14, 42.8%), diabetes (3/14, 21.4%), malignancy (2/14, 14.3%) and one patient each had paraplegy, AIDS and Chagas disease. Most of them were hospitalised due to pneumonia (7/14, 50.0%), sepsis (4/14, 28.6%), one patient each had ulcerations in the ankle and sacral region and one underwent eye surgery. Overall, 13 patients (92.9%) received previous broad-spectrum antibiotic therapy and central venous catheters, and mechanical ventilation were used for 10 patients (71.4%). Ten bacterial isolates were obtained by rubbing pre-moistened swabs over the sites in the immediate vicinity of the patient and the general areas in patients' rooms.

All isolates were shown to be resistant to vancomycin and teicoplanin, and the antimicrobial resistance mechanism is mediated by the vanA genes, which is consistent with our previous study with VREfm isolated at the hospital settings during 2002-2007. [1] All isolates also showed resistance to erythromycin that was mediated by ermB gene, which seems to be more widely distributed among VRE isolates. [2] Besides the glycopeptides and erythromycin resistance, all isolates were also resistant to ampicillin and ciprofloxacin that are characteristics of hospital-adapted E. faecium. [3] The Repetitive Extragenic Palindromic elements-PCR [4] detected 13 different clusters among the isolates, and 16 (66.7%) were clustered in five genotypes. The other eight (33.3%) isolates had unique banding profiles. All isolates harboured at least one putative virulence marker and the prevalence was as follows: efaA, 100%; esp, 75%; gelE, 41.7%. The genes acm, cylA and hyl were not detected in this study [Table 1].{Table 1}

The prevalence of E. faecium harbouring multiple antimicrobial resistance and putative virulence genes alert us for the potential risk of infection in hospitalised patients, corroborating to the importance of the control of healthcare-associated infections.

 Acknowledgements



This work was supported by grants from Pro-Reitoria de Pesquisa e Pσs-Graduaηγo (PROPPG) of Universidade Estadual de Londrina. This work was part of the M.Sc. dissertation of L.V.P. Gomes, which received studentship from Coordenaηγo de Aperfeiηoamento de Pessoal de Nνvel Superior-CAPES. We thank Dr. A. Leyva for English editing of the manuscript and Ediel Clementino da Costa for technical support. L.V.P.G.: Contributed in all methodological activities and, analysis and interpretation of data; A.T.M. and J.D.C: Nucleotide sequence analysis, primer design, analysis and interpretation of data; J.P.S. and C.F.O: Samples collection and isolates identification; L.M.Y. and M.R.E.P: Critical revision for important intellectual content. S.F.Y.O.: Conception, design, analysis and interpretation of data.

References

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