This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowReprints and Permissions
Right arrow Copyright Information
Right arrow Books from ASM Press
Right arrow MicrobeWorld
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Stampone, L.
Right arrow Articles by Pantosti, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Stampone, L.
Right arrow Articles by Pantosti, A.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, April 2005, p. 1575-1580, Vol. 43, No. 4
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.4.1575-1580.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Clonal Spread of a Vancomycin-Resistant Enterococcus faecium Strain among Bloodstream-Infecting Isolates in Italy

Lucia Stampone,1 Maria Del Grosso,1 Delia Boccia,2,{dagger} and Annalisa Pantosti1*

Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate,1 Centro Nazionale di Epidemiologia, Sorveglienza e Promozione della Salute, Istituto Superiore di Sanità, Rome, Italy2

Received 25 August 2004/ Returned for modification 7 October 2004/ Accepted 7 December 2004

Recent data indicated that the rate of vancomycin resistance in bloodstream-infecting enterococcal isolates in Italy is one of the highest in Europe. The aims of this study were to characterize bloodstream-infecting vancomycin-resistant enterococci (VRE) obtained from various Italian hospitals and to establish whether the isolates were clonally related. During the years 2001 to 2003, a total of 39 VRE isolates were obtained from 19 hospital laboratories in various areas of Italy. Species identification and resistance genotypes of the isolates were obtained by multiplex PCR. Further characterization included antibiotic susceptibility testing, pulsed-field gel electrophoresis (PFGE) of SmaI-digested genomic DNA, detection of virulence genes (esp and hyl), and multilocus sequence typing (MLST) of selected isolates. VRE were identified as 31 Enterococcus faecium (VREfm) isolates and 8 E. faecalis isolates. All but one isolate carried the vanA gene; one VREfm isolate carried the vanB gene. Analysis of the PFGE profiles showed that 28 VREfm isolates shared a similar electrophoretic profile, designed type 1, and were clonally related. All type 1 isolates were resistant to ampicillin, streptomycin, gentamicin, and rifampin and were positive for the esp gene. MLST identified an allelic profile (ST78) comprising purK allele 1, belonging to the C1 clonal lineage, characteristic of human infection and hospital outbreak isolates. The vanB-carrying VREfm isolate, of PFGE type 2, was shown to be a single-locus variant of ST78. Our data indicate that the recent increase in the number of bloodstream infections caused by VRE in Italy is due to the spread of a hospital-adapted, multidrug-resistant VREfm clone belonging to an internationally disseminated lineage.

* Corresponding author. Mailing address: Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy. Phone: (39) 064990 2852. Fax: (39) 0649387112. E-mail: pantosti{at}iss.it.

{dagger} Present address: Health Protection Agency (HPA), Communicable Disease Surveillance Centre, 61 Colindale Ave., London NW9 5EQ, United Kingdom. Phone: (44) 208 2006868. Fax: (44) 208 2007868. E-mail: delia.boccia{at}HPA.org.uk.

Journal of Clinical Microbiology, April 2005, p. 1575-1580, Vol. 43, No. 4
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.4.1575-1580.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Freitas, A. R., Novais, C., Ruiz-Garbajosa, P., Coque, T. M., Peixe, L. (2009). Dispersion of Multidrug-Resistant Enterococcus faecium Isolates Belonging to Major Clonal Complexes in Different Portuguese Settings. Appl. Environ. Microbiol. 75: 4904-4908 [Abstract] [Full Text]  
  • Abele-Horn, M., Vogel, U., Klare, I., Konstabel, C., Trabold, R., Kurihara, R., Witte, W., Kreth, W., Schlegel, P.-G., Claus, H. (2006). Molecular Epidemiology of Hospital-Acquired Vancomycin-Resistant Enterococci. J. Clin. Microbiol. 44: 4009-4013 [Abstract] [Full Text]  
  • Singh, A., Goering, R. V., Simjee, S., Foley, S. L., Zervos, M. J. (2006). Application of Molecular Techniques to the Study of Hospital Infection. Clin. Microbiol. Rev. 19: 512-530 [Abstract] [Full Text]  


Copyright © 2009 by the American Society for Microbiology.   For an alternate route to Journals.ASM.org, visit: http://intl-journals.asm.org | More Info»