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Clonal spread of CC17 vancomycin-resistant Enterococcus faecium with multilocus sequence type 78 (ST78) and a novel ST444 in Taiwan

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Abstract

From May 2007 to January 2008, 30 isolates of vancomycin-resistant enterococci (VRE), including 29 Enterococcus faecium (96.7%) and 1 E. faecalis (3.3%) were obtained from various clinical specimens of 30 patients treated at a university hospital in Taiwan. Among these patients, 27 had VRE infections, including urinary tract infection (n = 16), bacteremia (n = 5), wound infection (n = 5), and central nervous system infection (n = 1). Three patients had VRE colonization. All of these isolates belonged to the vanA genotype with vancomycin minimum inhibitory concentrations of 64≥128 μg/ml. The isolate of E. faecalis had VanB phenotype-vanA genotype. All these isolates were susceptible to linezolid and were inhibited by tigecycline at 0.25 μg/ml. Multilocus sequence typing (MLST) analysis of the E. faecium isolates showed that 82.8% were ST78, which belongs to lineage C1. Transposon typing classified the 30 isolates of VRE into three types and most of the Tn1546-like elements contained an IS1251-like insertion sequence. Mating experiments showed that the vanA gene clusters were transferable at a frequency of about 10−6 to 10−7. Our findings indicate that nosocomial spread of VRE resulted from dissemination of lineage C1 E. faecium clones, including a novel E. faecium MLST type (ST444), and the horizontal transfer of Tn1546 elements among enterococci.

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Authors and Affiliations

  1. Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Children’s Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan

    Y.-C. Hsieh

  2. Section of Infectious Disease, Department of Internal Medicine, Taipei Medical University-WanFang Hospital, Taipei, Taiwan

    W.-S. Lee & T.-Y. Ou

  3. Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, National Taiwan University Medical College, 7 Chung-Shan South Road, 100, Taipei, Taiwan

    P.-R Hsueh

Authors
  1. Y.-C. Hsieh
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  2. W.-S. Lee
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  3. T.-Y. Ou
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  4. P.-R Hsueh
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Correspondence to P.-R Hsueh.

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Y.-C. Hsieh and W.-S. Lee contributed equally to this work

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Hsieh, YC., Lee, WS., Ou, TY. et al. Clonal spread of CC17 vancomycin-resistant Enterococcus faecium with multilocus sequence type 78 (ST78) and a novel ST444 in Taiwan. Eur J Clin Microbiol Infect Dis 29, 25–30 (2010). https://doi.org/10.1007/s10096-009-0810-9

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  • DOI: https://doi.org/10.1007/s10096-009-0810-9

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