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Journal of Clinical Microbiology, June 2001, p. 2140-2145, Vol. 39, No. 6
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.6.2140-2145.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

High Prevalence of VanB2 Vancomycin-Resistant Enterococcus faecium in Taiwan

Jang-Jih Lu,* Cherng-Lih Perng, Ming-Fa Ho, Tzong-Shi Chiueh, and Wei-Hwa Lee

Division of Clinical Pathology and Experimental Pathology, Department of Pathology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, Republic of China

Received 22 January 2001/Returned for modification 11 March 2001/Accepted 17 March 2001

Thirty-six VanB glycopeptide-resistant Enterococcus faecium isolates were collected from patients in five different hospitals in Taiwan. The vancomycin resistance genes were amplified by the long vanB PCR, which amplifies the 6,373-bp vanB gene cluster including the vanRB2, vanSB2, vanYB2, vanWB2, vanHB2, vanB2, and vanXB2 genes. The deduced amino acid sequences were found to be 95 to 98% homologous to those of the vanB1 gene cluster: VanRB1, 97%; VanSB1, 97%; VanYB1, 96%; VanHB1, 95%; VanB1, 96%; and VanXB1, 98%. Restriction enzyme analysis of the long vanB PCR products revealed that all 36 isolates had the same vanB2-specific pattern. DNA sequence analysis of the vanB2 gene, which is a D-Ala-D-Lac ligase gene, revealed that none of the 36 sequences were identical to the previously published vanB2 sequence. Thirty-one isolates had 1 nucleotide different from the published vanB2 sequence. The sequences of the other five isolates differed from the published vanB2 sequence by 2 or 3 nucleotides. Four isolates with a low or moderate resistance to vancomycin (MIC = 4 to 32 µg/ml) were found to have the same leucine-to-methionine change at amino acid position 308 of the vanB2 gene. The genomic DNAs of all 36 isolates were digested with SmaI and then typed by pulsed-field gel electrophoresis (PFGE). Eight different PFGE types (I to VIII) were observed, and type I was found to be prevalent in all hospitals examined in this study. This result suggests that intra- and interhospital dissemination of this E. faecium strain has occurred in Taiwan.

* Corresponding author. Mailing address: Molecular Diagnostics Laboratory, Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, No. 325, Section 2, Chengkung Rd., Taipei 114, Taiwan, Republic of China. Phone: 886-2-87927227. Fax: 886-2-87927227. E-mail: jjl{at}ndmctsgh.edu.tw.

Journal of Clinical Microbiology, June 2001, p. 2140-2145, Vol. 39, No. 6
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.6.2140-2145.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.


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