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Journal of Clinical Microbiology, June 2006, p. 2220-2228, Vol. 44, No. 6
0095-1137/06/$08.00+0     doi:10.1128/JCM.02596-05
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Multilocus Sequence Typing Scheme for Enterococcus faecalis Reveals Hospital-Adapted Genetic Complexes in a Background of High Rates of Recombination

Patricia Ruiz-Garbajosa,1* Marc J. M. Bonten,2,3 D. Ashley Robinson,4 Janetta Top,2,3 Sreedhar R. Nallapareddy,5 Carmen Torres,6 Teresa M. Coque,1 Rafael Cantón,1 Fernando Baquero,1 Barbara E. Murray,5 Rosa del Campo,1 and Rob J. L. Willems2,3

Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Madrid, Spain,1 Eijkman-Winkler Institute for Microbiology, Infectious Diseases and Inflammation,2 Division of Acute Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Utrecht, The Netherlands,3 Department of Microbiology and Immunology, New York Medical College, Valhalla, New York,4 Center for the Study of Emerging and Reemerging Pathogens, University of Texas, Houston, Texas,5 Departamento de Agricultura y Alimentación, Universidad de La Rioja, Logroño, Spain6

Received 14 December 2005/ Returned for modification 1 February 2006/ Accepted 28 March 2006

A multilocus sequence typing (MLST) scheme based on seven housekeeping genes was used to investigate the epidemiology and population structure of Enterococcus faecalis. MLST of 110 isolates from different sources and geographic locations revealed 55 different sequence types that grouped into four major clonal complexes (CC2, CC9, CC10, and CC21) by use of eBURST. Two of these clonal complexes, CC2 and CC9, are particularly fit in the hospital environment, as CC2 includes the previously described BVE clonal complex identified by an alternative MLST scheme and CC9 includes exclusively isolates from hospitalized patients. Identical alleles were found in genetically diverse isolates with no linkage disequilibrium, while the different MLST loci gave incongruent phylogenetic trees. This demonstrates that recombination is an important mechanism driving genetic variation in E. faecalis and suggests an epidemic population structure for E. faecalis. Our novel MLST scheme provides an excellent tool for investigating local and short-term epidemiology as well as global epidemiology, population structure, and genetic evolution of E. faecalis.

* Corresponding author. Mailing address: Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Ctra. de Colmenar Km 9.100, Madrid 28034, Spain. Phone: 913368330. Fax: 913368809. E-mail: pruizg.hrc{at}salud.madrid.org.

Journal of Clinical Microbiology, June 2006, p. 2220-2228, Vol. 44, No. 6
0095-1137/06/$08.00+0     doi:10.1128/JCM.02596-05
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



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