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Abstract
A total of 58 vancomycin-resistant E. faecium (VREF) was isolated from 3 hospitals located in Daegu, Korea. The VREF isolates were evaluated for the antimicrobial susceptibility pattern and resistance determinants against vancomcin, aminoglycosides, and macrolides. The multilocus sequence types (MLST) were determined to characterize the clonal diversity of the VREF isolates. The VREF isolates were highly resistance to teicoplanin, erythromycin, ciprofloxacin, gentamicin, and streptomycin, whereas quinupristin-dalfopristin and linezolid were the most susceptible drugs. All isolates carried the vanA gene. The aac6′-aph2″ (n=53) and aadE (n=27) genes were detected in the high-level aminoglycoside resistant (HLAR) isolates. The aac6′-aph2″ gene was located in the conjugally transferable plasmids. The ermB and ermA genes were detected in the 54 and 3 VREF isolates, respectively. The VREF isolates showed 11 different sequence types (ST). The VREF isolates belonging to ST192 was the most prevalent (n=19), but detected in one hospital, whereas the isolates belonging to ST203 (n=11) were detected in 3 hospitals. These results suggest that the VREF isolates resistant to aminoglycosides and erythromycin are originated from different clones and specific VREF clones are spread in the study hospitals.
References
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Figure 1.
(A) CHEF electrophoresis of SmaI-digested genomic DNAs from the VREF isolates and their transconjugants. (B) Corresponding Southern blot hybridized with a aac6′-aph2″ gene probe. Lane M, Lambda ladder; lane N, recipient strain UW64/3 as a aac6′-aph2″ negative control; lane 1, 01DEM01; lane 2, pDEM01W; lane 3, 01YEM01; lane 4, pYEM01W; lane 5, 04KEM10; lane 6, pKEM10W; lane 7, 04KEM13; lane 8, pKEM13W; lane 9, 05KEM26; lane 10, pKEM26W.
Table 1.
Oligonucleotide primers used in this study
Table 2.
Antimicrobial susceptibility of vancomycin-resistant E. faecium isolates
| Antibiotics | 2001 (n=28) | 2004–2005 (n=30) | ||||
|---|---|---|---|---|---|---|
| MICb | No. (%) of isolates | MIC | No. (%) of isolates | |||
| 50% | 90% | 50% | 90% | |||
| Teicoplanin | 32 | 64 | 19 (67.9) | 32 | 256 | 24 (80.0) |
| Erythromycin | >256 | >256 | 28 (100) | >256 | >256 | 29 (96.7) |
| Ciprofloxacin | >32 | >32 | 23 (82.1) | >32 | >32 | 29 (96.7) |
| Nitrofurantoin | 64 | 64 | 1 (3.6) | 256 | 256 | 20 (66.7) |
| Q/Da | 2 | 2 | 2 (7.1) | 2 | 2 | 1 (3.3) |
| Linezolid | 2 | 2 | 0 | 2 | 2 | 0 |
| Gentamicin | >2,048 | >2,048 | 27 (96.4) | 2048 | >2,048 | 26 (86.7) |
| Streptomycin | 512 | >2,048 | 17 (60.7) | 64 | >2,048 | 10 (33.3) |
Table 3.
Distribution of antimicrobial resistant genes of vancomycin-resistant E. faecium isolates
| No. (%) of is olates | ||||
|---|---|---|---|---|
| Isolation year (No. of isolates) | HLARa | Erythromycin | ||
| aac6′-aph2″ | aadE | ermA | ermB | |
| 2001 (n=28) | 27 (46.6) | 17 (29.3) | 3 (5.2) | 25 (43.1) |
| 2004∼2005 (n=30) | 26 (44.8) | 10 (17.3) | 0 (0.0) | 29 (50.0) |
| Total (n=58) | 53 (91.4) | 27 (46.6) | 3 (5.2) | 54 (93.1) |
Table 4.
Distribution of sequence types of vancomycin-resistant E. faecium isolates
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