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Journal of Clinical Microbiology, 09 1997, 2342-2347, Vol 35, No. 9
DE Perlada, AG Smulian and MT Cushion
To determine patterns of antimicrobial susceptibility among enterococci and
to assess molecular characteristics of vancomycin-resistant enterococci,
157 clinical blood isolates of enterococci from 10 hospitals in Cincinnati,
Ohio, were prospectively collected during a 6- month period from February
to July 1995. The isolates included 108 (69%) E. faecalis isolates, 46
(29%) E. faecium isolates, and 1 isolate each of E. avium, E. durans, and
E. gallinarum. The E. faecalis and E. faecium isolates differed in their
susceptibilities to ampicillin (100 versus 20%), ampicillin-sulbactam (100
versus 13%), vancomycin (100 versus 57%), imipenem (94 versus 2%), and high
levels of gentamicin (59 versus 83%). Supplemental susceptibility testing
of the 21 vancomycin- resistant isolates showed that 21 (100%) were
susceptible to chloramphenicol and that only 7 (33%) were susceptible to
doxycycline. Nineteen (90%) of the vancomycin-resistant E. faecium isolates
were of the VanB phenotype, with vanB resistance genes detected by PCR and
hybridization with gene-specific probes; and the E. gallinarum isolates
demonstrated the VanC phenotype with the vanC1 gene. One vancomycin-
resistant E. faecium isolate was highly resistant to both teicoplanin and
vancomycin, corresponding to the VanA phenotype; however, it was found to
have the vanB gene. Pulsed-field gel electrophoresis (PFGE) revealed that
all of the 19 E. faecium isolates with the VanB phenotype had identical to
closely related banding patterns. Hybridization of restriction
enzyme-digested DNA separated by PFGE with a vanB gene probe demonstrated
differences in the locations of vanB genes that corresponded closely to the
PFGE banding patterns. Our study has documented that the emerging
vancomycin resistance in our city was mainly due to the clonal
dissemination of a single strain of E. faecium VanB.
Copyright © 1997 by the American Society for Microbiology. All rights reserved.
Molecular epidemiology and antibiotic susceptibility of enterococci in Cincinnati, Ohio: a prospective citywide survey
Department of Medicine, University of Cincinnati College of Medicine, Ohio 45267-0560, USA.
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