Global Spread of Vancomycin-resistant Enterococcus Faecium from Distinct Nosocomial Genetic Complex

Overview

Journal Emerg Infect Dis

Specialty Infectious Diseases

Date 2005 Jun 21

PMID 15963275

Citations 180

Authors

Rob J L Willems

Janetta Top

Marga van Santen

D Ashley Robinson

Teresa M Coque

Fernando Baquero

Hajo Grundmann

Marc J M Bonten

Affiliations

Soon will be listed here.

Abstract

Vancomycin-resistant enterococci (VRE) have caused hospital outbreaks worldwide, and the vancomycin-resistance gene (vanA) has crossed genus boundaries to methicillin-resistant Staphylococcus aureus. Spread of VRE, therefore, represents an immediate threat for patient care and creates a reservoir of mobile resistance genes for other, more virulent pathogens. Evolutionary genetics, population structure, and geographic distribution of 411 VRE and vancomycin-susceptible Enterococcus faecium isolates, recovered from human and nonhuman sources and community and hospital reservoirs in 5 continents, identified a genetic lineage of E. faecium (complex-17) that has spread globally. This lineage is characterized by 1) ampicillin resistance, 2) a pathogenicity island, and 3) an association with hospital outbreaks. Complex-17 is an example of cumulative evolutionary processes that improved the relative fitness of bacteria in hospital environments. Preventing further spread of this epidemic E. faecium subpopulation is critical, and efforts should focus on the early disclosure of ampicillin-resistant complex-17 strains.

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References

Jureen R, Top J, Mohn S, Harthug S, Langeland N, Willems R . Molecular characterization of ampicillin-resistant Enterococcus faecium isolates from hospitalized patients in Norway. J Clin Microbiol. 2003; 41(6):2330-6. PMC: 156547. DOI: 10.1128/JCM.41.6.2330-2336.2003. View

Goossens H, Jabes D, Rossi R, Lammens C, Privitera G, Courvalin P . European survey of vancomycin-resistant enterococci in at-risk hospital wards and in vitro susceptibility testing of ramoplanin against these isolates. J Antimicrob Chemother. 2003; 51 Suppl 3:iii5-12. DOI: 10.1093/jac/dkg271. View

Leavis H, Top J, Shankar N, Borgen K, Bonten M, van Embden J . A novel putative enterococcal pathogenicity island linked to the esp virulence gene of Enterococcus faecium and associated with epidemicity. J Bacteriol. 2004; 186(3):672-82. PMC: 321477. DOI: 10.1128/JB.186.3.672-682.2004. View

Morelli G, Malorny B, Muller K, Seiler A, Wang J, Del Valle J . Clonal descent and microevolution of Neisseria meningitidis during 30 years of epidemic spread. Mol Microbiol. 1997; 25(6):1047-64. DOI: 10.1046/j.1365-2958.1997.5211882.x. View

Willems R, Top J, van den Braak N, van Belkum A, Endtz H, Mevius D . Host specificity of vancomycin-resistant Enterococcus faecium. J Infect Dis. 2000; 182(3):816-23. DOI: 10.1086/315752. View

Uttley A, Collins C, Naidoo J, George R . Vancomycin-resistant enterococci. Lancet. 1988; 1(8575-6):57-8. DOI: 10.1016/s0140-6736(88)91037-9. View

Leavis H, Willems R, Top J, Spalburg E, Mascini E, Fluit A . Epidemic and nonepidemic multidrug-resistant Enterococcus faecium. Emerg Infect Dis. 2003; 9(9):1108-15. PMC: 3016763. DOI: 10.3201/eid0909.020383. View

Willems R, Homan W, Top J, Tribe D, Manzioros X, Gaillard C . Variant esp gene as a marker of a distinct genetic lineage of vancomycin-resistant Enterococcus faecium spreading in hospitals. Lancet. 2001; 357(9259):853-5. DOI: 10.1016/S0140-6736(00)04205-7. View

Bonora M, Ligozzi M, de Fatima M, Bragagnolo L, Goglio A, Guazzotti G . Vancomycin-resistant Enterococcus faecium isolates causing hospital outbreaks in northern Italy belong to the multilocus sequence typing C1 lineage. Microb Drug Resist. 2004; 10(2):114-23. DOI: 10.1089/1076629041310046. View

10.

Robinson D, Enright M . Evolutionary models of the emergence of methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother. 2003; 47(12):3926-34. PMC: 296208. DOI: 10.1128/AAC.47.12.3926-3934.2003. View

11.

Routsi C, Platsouka E, Willems R, Bonten M, Paniara O, Saroglou G . Detection of enterococcal surface protein gene (esp) and amplified fragment length polymorphism typing of glycopeptide-resistant Enterococcus faecium during its emergence in a Greek intensive care unit. J Clin Microbiol. 2003; 41(12):5742-6. PMC: 308986. DOI: 10.1128/JCM.41.12.5742-5746.2003. View

12.

Chang S, Sievert D, Hageman J, Boulton M, Tenover F, Downes F . Infection with vancomycin-resistant Staphylococcus aureus containing the vanA resistance gene. N Engl J Med. 2003; 348(14):1342-7. DOI: 10.1056/NEJMoa025025. View

13.

Simonsen G, Smabrekke L, Monnet D, Sorensen T, Moller J, Kristinsson K . Prevalence of resistance to ampicillin, gentamicin and vancomycin in Enterococcus faecalis and Enterococcus faecium isolates from clinical specimens and use of antimicrobials in five Nordic hospitals. J Antimicrob Chemother. 2003; 51(2):323-31. DOI: 10.1093/jac/dkg052. View

14.

Weigel L, Clewell D, Gill S, Clark N, McDougal L, Flannagan S . Genetic analysis of a high-level vancomycin-resistant isolate of Staphylococcus aureus. Science. 2003; 302(5650):1569-71. DOI: 10.1126/science.1090956. View

15.

Bonten M, Willems R, Weinstein R . Vancomycin-resistant enterococci: why are they here, and where do they come from?. Lancet Infect Dis. 2002; 1(5):314-25. DOI: 10.1016/S1473-3099(01)00145-1. View

16.

Shin J, Yong D, Kim M, Chang K, Lee K, Kim J . Sudden increase of vancomycin-resistant enterococcal infections in a Korean tertiary care hospital: possible consequences of increased use of oral vancomycin. J Infect Chemother. 2003; 9(1):62-7; discussion 104-5. DOI: 10.1007/s10156-002-0215-5. View

17.

Brueggemann A, Griffiths D, Meats E, Peto T, Crook D, Spratt B . Clonal relationships between invasive and carriage Streptococcus pneumoniae and serotype- and clone-specific differences in invasive disease potential. J Infect Dis. 2003; 187(9):1424-32. DOI: 10.1086/374624. View

18.

Bouchillon S, Johnson B, Hoban D, Johnson J, Dowzicky M, Wu D . Determining incidence of extended spectrum beta-lactamase producing Enterobacteriaceae, vancomycin-resistant Enterococcus faecium and methicillin-resistant Staphylococcus aureus in 38 centres from 17 countries: the PEARLS study 2001-2002. Int J Antimicrob Agents. 2004; 24(2):119-24. DOI: 10.1016/j.ijantimicag.2004.01.010. View

19.

Cetinkaya Y, Falk P, Mayhall C . Vancomycin-resistant enterococci. Clin Microbiol Rev. 2000; 13(4):686-707. PMC: 88957. DOI: 10.1128/CMR.13.4.686. View

20.

Ridwan B, Mascini E, van Der Reijden N, Verhoef J, Bonten M . What action should be taken to prevent spread of vancomycin resistant enterococci in European hospitals?. BMJ. 2002; 324(7338):666-8. PMC: 1122583. DOI: 10.1136/bmj.324.7338.666. View