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Journal of Clinical Microbiology, June 2003, p. 2330-2336, Vol. 41, No. 6
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.6.2330-2336.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Molecular Characterization of Ampicillin-Resistant Enterococcus faecium Isolates from Hospitalized Patients in Norway

Roland Jureen,1* Janetta Top,2 Stein Christian Mohn,1 Stig Harthug,3 Nina Langeland,1 and Rob J. L. Willems2

Institute of Medicine, University of Bergen,1 Department of Medicine, Haukeland University Hospital, Bergen, Norway,3 Diagnostic Laboratory for Infectious Diseases and Perinatal Screening, National Institute for Public Health and the Environment, Bilthoven, The Netherlands2

Received 12 November 2002/ Returned for modification 12 December 2002/ Accepted 14 March 2003

The genetic relationship of 81 ampicillin-resistant and 21 ampicillin-susceptible Enterococcus faecium isolates from clinical infections and rectal screening in hospitalized patients in Norway was studied by pulsed-field gel electrophoresis (PFGE) and amplified fragment length polymorphism (AFLP). PFGE showed 55 different banding patterns, and 65 of the isolates could be grouped into one large group. With AFLP, 46 patterns were discerned, and 74 isolates clustered in one group. In general, the isolates had a higher degree of similarity than with PFGE. The purK gene, which is one of the targets of the E. faecium multilocus sequence typing scheme, was sequenced. Eleven different purK alleles could be discerned, with the majority of isolates (n = 80) harboring allele 1. With only two exceptions, all strains carrying purK-1 clustered in the same PFGE and AFLP groups, indicating a good correlation between PFGE type, AFLP type, and purK allele. Genetic polymorphism of a 571-bp PCR fragment of the C-terminal domain of the penicillin-binding protein 5 gene (pbp5) was determined, and sequence differences were associated with the level of ampicillin resistance. This study indicates that the majority of ampicillin-resistant E. faecium strains in Norway belong to a distinct genetic lineage of closely related genotypes. Rectal and clinical isolates were generally indistinguishable, and differences in clonal distribution and allele polymorphism were found mainly between ampicillin-resistant and -susceptible isolates.

* Corresponding author. Mailing address: Institute of Medicine, University of Bergen, Haukeland University Hospital, 5021 Bergen, Norway. Phone: 4755973075. Fax: 4755975890. E-mail: roland.jureen{at}med.uib.no.

Journal of Clinical Microbiology, June 2003, p. 2330-2336, Vol. 41, No. 6
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.6.2330-2336.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.



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