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KMID : 0829320150180030076
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Korean Journal of Clinical Microbiology
2015 Volume.18 No. 3 p.76 ~ p.81
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Epidemiology and Molecular Characterization of Vancomycin-Resistant Enterococcus faecalis
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Kim Joon
Choi Kyung-Ho
Kim Young-Sun
Lee Wee-Gyo
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Abstract
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Background: Vancomycin-resistant Enterococci (VRE) infections are caused by Enterococcus faecium in about 90% of the cases but can also be caused by Enterococcus faecalis. Thus, this study investigates factors that cause a low isolation rate of vancomycin-resistant E. faecalis (VREfs). To this end, the authors study the clinical traits, resistant gene structure,
genomic classification, and molecular characteristics of the virulent factor.
Methods: From January 2001 through September 2011, 17 vanA-containing E. faecalis isolates were collected from hospitalized patients at Ajou University Hospital in Korea. Identification, antimicrobial susceptibility testing, and PCR of van and esp genes were performed. Pulsed-field gel electrophoresis (PFGE) was used for strain typing. PCR and sequencing of the internal regions of Tn1546 were performed for structural analysis of the van gene.
Results: Of 4,235 VRE infections, 3,918 (92.5%) were caused by E. faecium, and 95 (2.2%) were caused by E. faecalis. In 67% of VREfs infections, there was a preceding occurrence of E. faecium infection. All isolates were of genotype vanA. Our isolates were divided into three types according to the distribution of IS elements integrated into Tn1546 (types I to IIb). The
PFGE results showed no clonal relatedness among isolates.
Conclusion: Our study found that VREfs infections affect patients who have experienced vancomycin-resistant E. faecium. (VREfm) infection or undergo invasive procedures. The VREfs seems to involve the horizontal transfer of Tn1546 transposon from VREfm.
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KEYWORD
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IS1216V, IS1542, Tn1546, Vancomycinresistant Enterococcus faecalis
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