Characterization of a Vancomycin-resistant Enterococcus faecium Outbreak Caused by 2 Genetically Different Clones at a Neonatal Intensive Care Unit
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In July 2010, we identified an outbreak of vancomycin-resistant enterococci (VRE) in our 26-bed neonatal intensive care unit. We performed an epidemiological investigation after clinical cultures of 2 neonates were positive for VRE. Identification, susceptibility testing, and molecular characterization were performed. Cultures of 3 surveillance stool samples of inpatients and 5 environmental samples were positive for VRE. All isolates were identified as Enterococcus faecium containing the vanA gene. Two distinct clones were identified by performing pulsed-field gel electrophoresis. The 2 clones exhibited different pulsotypes, but they represented identical Tn1546 types. Two sequence types, ST18 and ST192, were identified among all of the isolates with multilocus sequence typing. Our investigation determined that the outbreak in the neonatal intensive care unit was caused by 2 genetically different clones. The outbreak may have occurred through clonal spread and horizontal transfer of the van gene.
Abstract
In July 2010, we identified an outbreak of vancomycin-resistant enterococci (VRE) in our 26-bed neonatal intensive care unit. We performed an epidemiological investigation after clinical cultures of 2 neonates were positive for VRE. Identification, susceptibility testing, and molecular characterization were performed. Cultures of 3 surveillance stool samples of inpatients and 5 environmental samples were positive for VRE. All isolates were identified as Enterococcus faecium containing the vanA gene. Two distinct clones were identified by performing pulsed-field gel electrophoresis. The 2 clones exhibited different pulsotypes, but they represented identical Tn1546 types. Two sequence types, ST18 and ST192, were identified among all of the isolates with multilocus sequence typing. Our investigation determined that the outbreak in the neonatal intensive care unit was caused by 2 genetically different clones. The outbreak may have occurred through clonal spread and horizontal transfer of the van gene.
참고문헌 (17)
- Cetinkaya Y, "Vancomycin-resistant enterococci", Clin Microbiol Rev, 13, pp.686~707 (2000)
- Lee WG, "Relapse and reacquisition of rectal colonization by vancomycin-resistant Enterococcus faecium after decolonization", Epidemiol Infect, 138, pp.1449~1453 (2010)
- Montecalvo MA, "Natural history of colonization with vancomycin-resistant Enterococcus faecium", Infect Control Hosp Epidemiol, 16, pp.680~685 (1995)
- Gholizadeh Y, "Acquired and intrinsic glycopeptide resistance in enterococci", Int J Antimicrob Agents, 16(S1), pp.S11~S17 (2000)
- Sherer CR, "Characterizing vancomycin-resistant enterococci in neonatal intensive care", Emerg Infect Dis, 11, pp.1470~1472 (2005)
- Singh N, "Control of vancomycin-resistant enterococci in the neonatal intensive care unit", Infect Control Hosp Epidemiol, 26, pp.646~649 (2005)
- Ergaz Z, "Elimination of vancomycin-resistant enterococci from a neonatal intensive care unit following an outbreak", J Hosp Infect, 74, pp.370~376 (2010)
- Yüce A, "Vancomycin-resistant enterococci in neonates", Scand J Infect Dis, 33, pp.3~5 (2001)
- Tenover FC, "Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing", J Clin Microbiol, 33, pp.2233~2239 (1995)
- Dutka-Malen S, "Detection of glycopeptide resistance genotypes and identification to the species level of clinically relevant enterococci by PCR", J Clin Microbiol, 33, pp.1434~ (1995)
- Woodford N, "Diversity of VanA glycopeptide resistance elements in enterococci from humans and nonhuman sources", Antimicrob Agents Chemother, 42, pp.502~508 (1998)
- Homan WL, "Multilocus sequence typing scheme for Enterococcus faecium", J Clin Microbiol, 40, pp.1963~1971 (2002)
- Freitas AR, "Global spread of the hyl(Efm) colonization-virulence gene in megaplasmids of the Entercoccus faecium CC17 polyclonal subcluster", Antimicrob Agents Chemother, 54, pp.2660~665 (2010)
- Galloway-Peña JR, "Analysis of clonality and antibiotic resistance among early clinical isolates of Enterococcus faecium in the United States", J Infect Dis, 200, pp.1566~1573 (2009)
- Bonora MG, "Phylogenetic analysis of vancomycin-resistant Enterococcus faecium genotypes associated with outbreaks or sporadic infections in Italy", Microb Drug Resist, 13, pp.171~177 (2007)
- Leavis HL, "Identification of high-risk enterococcal clonal complexes: global dispersion and antibiotic resistance", Curr Opin Microbiol, 9, pp.454~460 (2006)
- Klare I, "Spread of ampicillin", vancomycin-resistant Enterococcus faecium of the epidemic-virulent clonal complex-17 carrying the genes esp and hyl in German hospitals, 2005, pp.24, 815~825