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Journal of Clinical Microbiology, January 2007, p. 147-153, Vol. 45, No. 1
0095-1137/07/$08.00+0     doi:10.1128/JCM.01704-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Clonal Structure of Enterococcus faecalis Isolated from Polish Hospitals: Characterization of Epidemic Clones

Magdalena Kawalec,^1* Zbigniew Pietras,² Emilia Daniowicz,³ Aleksandra Jakubczak,² Marek Gniadkowski,¹ Waleria Hryniewicz,¹ and Rob J. L. Willems⁴

National Institute of Public Health, 00-725 Warsaw, Poland,¹ Institute of Microbiology, Faculty of Biology, Warsaw University, 02-096 Warsaw, Poland,² Warsaw Agriculture University, Faculty of Biotechnology, 02-798 Warsaw, Poland,³ University Medical Center Utrecht Eijkman-Winkler Laboratory for Microbiology, Infectious Diseases and Inflammation, 3584 CX Utrecht, The Netherlands⁴

Received 17 August 2006/ Returned for modification 16 October 2006/ Accepted 29 October 2006

To study the population structure of Enterococcus faecalis from Polish hospitals, 291 isolates were typed by pulsed-field gel electrophoresis and a novel multilocus sequence typing scheme (P. Ruiz-Garbajosa et al., J. Clin. Microbiol. 44:2220-2228, 2006). The isolates originated from geographically widespread medical institutions and were recovered during a 10-year period (1996 to 2005) from different clinical sources. The analysis grouped the isolates into five epidemic and 71 sporadic clones. The importance of the previously identified global clonal complexes CC2 and CC9 was corroborated by our findings that two of the Polish epidemic clones, A and J, were classified into these clonal complexes (CCs). However, the two most predominant clones, C (ST40) and F (CC87), did not cluster in the aforementioned CCs and may represent novel epidemic CCs. These clones may have emerged in Central Europe. Clone F, carrying glycopeptide resistance determinants of VanA or VanB phenotypes, caused several outbreaks in hematology units and appeared to be the most prevalent clone in recent years in Poland. Antimicrobial susceptibility testing and additional tests for pathogenicity-related phenotypes (hemolysin and gelatinase production) and genes (asa1 and esp) were performed to further characterize these epidemic clones. Multidrug resistance, glycopeptide resistance, presence of asa1, and production of hemolysin appeared to be statistically significant features related to epidemicity. Production of gelatinase was significant for two of the epidemic clones, whereas presence of the esp gene was not specific for the epidemic clones.

Published ahead of print on 8 November 2006.

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