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Journal of Clinical Microbiology, May 2004, p. 1897-1902, Vol. 42, No. 5
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.5.1897-1902.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Distribution of Insertion Sequences Associated with Tn1546-Like Elements among Enterococcus faecium Isolates from Patients in Korea

Ji Young Huh,1 Wee Gyo Lee,1* Kyungwon Lee,2 Wan Shik Shin,3 and Jin Hong Yoo3

Department of Laboratory Medicine, Ajou University School of Medicine, Suwon,1 Department of Laboratory Medicine, Yonsei University School of Medicine,2 Department of Internal Medicine, Catholic University School of Medicine, Seoul, Korea3

Received 23 September 2003/ Returned for modification 15 December 2003/ Accepted 27 January 2004

The vanA gene cluster is carried as a part of Tn1546-like elements. The genetic diversity in Tn1546-like elements has been documented previously. The differences described thus far have included the integration of insertion sequence (IS) elements IS1216V, IS1251, IS1476, and IS1542. Among these, IS1216V has been reported to be widespread in VanA enterococci of diverse geographic areas, whereas IS1542 and IS1476 have been reported only in the United Kingdom and Canada, respectively. We investigated the distribution of ISs among 20 vanA-containing Enterococcus faecium isolates from human patients in nine different university hospitals in Korea. Pulsed-field gel electrophoresis (PFGE) was performed to identify the clonality of the isolates. Moreover, PCR amplification of the internal regions of Tn1546 was performed for structural analysis of the van gene, and both DNA strands of the PCR amplicons were directly sequenced by the dideoxy termination method. The PFGE patterns revealed a high degree of clonal diversity. Structural analyses of the van gene detected IS1542 and IS1216V in the genomes of all 20 isolates, whereas it did not detect IS1476 or IS1251 in the genomes of any of the isolates. In addition, IS19 was detected in the vanS-vanH intergenic region of one isolate. These data indicate that identification of the IS within a vanA gene cluster could be a useful tool in epidemiological investigations. In addition, the distribution of ISs associated with Tn1546-like elements among the Korean isolates is therefore similar to that among European vancomycin-resistant enterococci.

* Corresponding author. Mailing address: Department of Laboratory Medicine, Ajou University Hospital, San 5, Wonchun-Dong, Paldal-Gu, Suwon 442-749, South Korea. Phone: 82-31-219-5785. Fax: 82-31-219-5778. E-mail: weegyo{at}ajou.ac.kr.

Journal of Clinical Microbiology, May 2004, p. 1897-1902, Vol. 42, No. 5
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.5.1897-1902.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



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