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Journal of Clinical Microbiology, November 1998, p. 3303-3308, Vol. 36, No. 11
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Molecular Analysis of Glycopeptide-Resistant
Enterococcus faecium Isolates Collected from Michigan
Hospitals over a 6-Year Period
LeeAnn
Thal,1,2,3,4
Susan
Donabedian,1,2,3,4
Barbara
Robinson-Dunn,5,6
Joseph W.
Chow,1,3
Louise
Dembry,1,3,8,9
Don B.
Clewell,10,11
Drew
Alshab,5,6 and
Marcus J.
Zervos1,2,3,4,8,12,13,*
Departments of
Medicine,1
Epidemiology,8
Clinical Pathology,2
Biologic and Materials
Sciences,10
Microbiology,12 and
Immunology13 and
Sections of Infectious
Disease3 and
Microbiology and Disease
Surveillance,5 Wayne State University,
Detroit,7
William Beaumont Hospital, Royal
Oak,4
Michigan Department of Community Health,
Lansing,6 and
The University of Michigan,
Ann Arbor,11 Michigan, and
Yale University
School of Medicine, New Haven, Connecticut9
Received 9 February 1998/Returned for modification 2 June
1998/Accepted 18 August 1998
The purpose of this study was to evaluate the molecular relatedness
of clinical isolates of glycopeptide-resistant Enterococcus faecium isolates collected from hospitals in Michigan. A total of
379 isolates used in this study were all vancomycin-resistant E. faecium isolates collected from 28 hospitals and three
extended-care facilities over a 6-year period from 1991 to 1996. For
the 379 isolates, there were 73 pulsed-field gel electrophoresis (PFGE) strain types. Within strain types, there were as many as six
restriction fragment differences. Most isolates (70%) belonged to six
strain types, which were designated M1 (36%), M2 (3%), M3 (18%), M4
(6%), M10 (4%), and M11 (3%). PFGE strain M1 was cultured from 135 patients in 13 hospitals during the period 1993 to 1996. Strain type M2 was cultured from 11 patients in two hospitals during the period 1991 to 1992 and was not observed after 1992. Strain type M3 was cultured
from 70 patients in 10 hospitals during the period of 1994 to 1996. Both M4 and M10 were cultured from 23 patients in three hospitals and
from 15 patients in two hospitals, respectively, during 1995 to 1996. M11 was cultured from 13 patients in four hospitals during 1996. A
total of 23 of 28 hospitals had evidence of clonal dissemination of
some isolates. Plasmid content and hybridization analysis done on 103 isolates from one hospital and two affiliated extended-care facilities
indicated that the strains contained from one to eight plasmids. Mating
experiments indicated transfer of vancomycin resistance from 94 of
these isolates into plasmid-free E. faecium GE-1 at
transfer frequencies of <10
9 to 10
4.
Gentamicin resistance and erythromycin resistance were cotransferred at
various frequencies. A probe for the vanA gene hybridized
to the plasmids of 23 isolates and to the chromosomes of 72 isolates. A
probe for the vanB gene hybridized to the chromosomes of 8 isolates. The results of this study suggest inter- and intrahospital
dissemination of vancomycin-resistant E. faecium strains
over a 6-year period in southeastern Michigan. The majority of isolates
studied belonged to the same few PFGE strains, indicating that clonal
dissemination was responsible for most of the spread of resistance that
occurred.
*
Corresponding author. Mailing address: William Beaumont
Hospital, 3601 West 13 Mile Rd., Royal Oak, MI 48073. Phone: (248) 551-0419. Fax: (248) 551-8880. E-mail: MZervos{at}Beaumont.edu.
Journal of Clinical Microbiology, November 1998, p. 3303-3308, Vol. 36, No. 11
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
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Copyright © 1998 by the American Society for Microbiology. All rights reserved.