VanA-Enterococcus Faecalis in Poland: Hospital Population Clonal Structure and VanA Mobilome

Overview

Journal Eur J Clin Microbiol Infect Dis

Publisher Springer

Specialties Infectious Diseases
Microbiology

Date 2022 Sep 3

PMID 36057762

Authors

Ewa Wardal

Dorota Zabicka

Waleria Hryniewicz

Ewa Sadowy

Affiliations

Soon will be listed here.

Abstract

The aim of our study was to characterize the epidemiological situation concerning nosocomial vancomycin-resistant Enterococcus faecalis of VanA-phenotype (VREfs-VanA) in Poland by investigating their clonal relationships and the vanA-associated mobilome. One-hundred twenty-five clinical isolates of VREfs-VanA collected between 2004 and 2016 were studied by phenotypic assays, multilocus sequence typing (MLST), pulsed-field gel electrophoresis (PFGE), PCR detection of plasmid-specific genes, and Tn1546 structure and localization mapping. Selected isolates were subjected to PFGE-S1, Southern hybridization, genomic sequencing and conjugation experiments. The majority of isolates (97.6%) belonged to clonal complexes CC2 and CC87 of E. faecalis. All isolates were resistant to vancomycin and teicoplanin, and resistance to ciprofloxacin and aminoglycosides (high level) was very prevalent in this group. VanA phenotype was associated with 16 types of Tn1546, carrying insertion sequences IS1216, ISEfa4, IS1251 and IS1542, located on repUS1, rep1, rep2, rep9 and rep6 replicons. The most common Tn1546 B- and BB-type transposons, harbouring one or two copies of IS1216, were inserted between rep18a and repUS1 genes and located on ~ 20 kb and 150-200 kb plasmids. VREfs-VanA in Poland represent a polyclonal group, indicating a number of acquisitions of the vanA determinant. The repUS1-vanA plasmids, unique for Poland, were the main factor beyond the acquisition of vancomycin resistance by E. faecalis, circulating in Polish hospitals.

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References

Clark N, Cooksey R, Hill B, Swenson J, Tenover F . Characterization of glycopeptide-resistant enterococci from U.S. hospitals. Antimicrob Agents Chemother. 1993; 37(11):2311-7. PMC: 192384. DOI: 10.1128/AAC.37.11.2311. View

Chen Y, Staddon J, Dunny G . Specificity determinants of conjugative DNA processing in the Enterococcus faecalis plasmid pCF10 and the Lactococcus lactis plasmid pRS01. Mol Microbiol. 2007; 63(5):1549-64. PMC: 2650854. DOI: 10.1111/j.1365-2958.2007.05610.x. View

Rosvoll T, Pedersen T, Sletvold H, Johnsen P, Sollid J, Simonsen G . PCR-based plasmid typing in Enterococcus faecium strains reveals widely distributed pRE25-, pRUM-, pIP501- and pHTbeta-related replicons associated with glycopeptide resistance and stabilizing toxin-antitoxin systems. FEMS Immunol Med Microbiol. 2009; 58(2):254-68. DOI: 10.1111/j.1574-695X.2009.00633.x. View

Pontinen A, Top J, Arredondo-Alonso S, Tonkin-Hill G, Freitas A, Novais C . Apparent nosocomial adaptation of Enterococcus faecalis predates the modern hospital era. Nat Commun. 2021; 12(1):1523. PMC: 7943827. DOI: 10.1038/s41467-021-21749-5. View

Garcillan-Barcia M, Francia M, de la Cruz F . The diversity of conjugative relaxases and its application in plasmid classification. FEMS Microbiol Rev. 2009; 33(3):657-87. DOI: 10.1111/j.1574-6976.2009.00168.x. View

Francia M, Clewell D . Amplification of the tetracycline resistance determinant of pAMalpha1 in Enterococcus faecalis requires a site-specific recombination event involving relaxase. J Bacteriol. 2002; 184(18):5187-93. PMC: 135321. DOI: 10.1128/JB.184.18.5187-5193.2002. View

Buetti N, Wassilew N, Rion V, Senn L, Gardiol C, Widmer A . Emergence of vancomycin-resistant enterococci in Switzerland: a nation-wide survey. Antimicrob Resist Infect Control. 2019; 8:16. PMC: 6337856. DOI: 10.1186/s13756-019-0466-x. View

Wardal E, Markowska K, Zabicka D, Wroblewska M, Giemza M, Mik E . Molecular analysis of vanA outbreak of Enterococcus faecium in two Warsaw hospitals: the importance of mobile genetic elements. Biomed Res Int. 2014; 2014:575367. PMC: 4070583. DOI: 10.1155/2014/575367. View

Zhu W, Murray P, Huskins W, Jernigan J, McDonald L, Clark N . Dissemination of an Enterococcus Inc18-Like vanA plasmid associated with vancomycin-resistant Staphylococcus aureus. Antimicrob Agents Chemother. 2010; 54(10):4314-20. PMC: 2944587. DOI: 10.1128/AAC.00185-10. View

10.

Wang G, Yu F, Lin H, Murugesan K, Huang W, Hoss A . Evolution and mutations predisposing to daptomycin resistance in vancomycin-resistant Enterococcus faecium ST736 strains. PLoS One. 2018; 13(12):e0209785. PMC: 6303062. DOI: 10.1371/journal.pone.0209785. View

11.

Freitas A, Coque T, Novais C, Hammerum A, Lester C, Zervos M . Human and swine hosts share vancomycin-resistant Enterococcus faecium CC17 and CC5 and Enterococcus faecalis CC2 clonal clusters harboring Tn1546 on indistinguishable plasmids. J Clin Microbiol. 2011; 49(3):925-31. PMC: 3067689. DOI: 10.1128/JCM.01750-10. View

12.

Sletvold H, Johnsen P, Wikmark O, Simonsen G, Sundsfjord A, Nielsen K . Tn1546 is part of a larger plasmid-encoded genetic unit horizontally disseminated among clonal Enterococcus faecium lineages. J Antimicrob Chemother. 2010; 65(9):1894-906. PMC: 2920175. DOI: 10.1093/jac/dkq219. View

13.

Kawalec M, Pietras Z, Danilowicz E, Jakubczak A, Gniadkowski M, Hryniewicz W . Clonal structure of Enterococcus faecalis isolated from Polish hospitals: characterization of epidemic clones. J Clin Microbiol. 2006; 45(1):147-53. PMC: 1828945. DOI: 10.1128/JCM.01704-06. View

14.

Page A, Cummins C, Hunt M, Wong V, Reuter S, Holden M . Roary: rapid large-scale prokaryote pan genome analysis. Bioinformatics. 2015; 31(22):3691-3. PMC: 4817141. DOI: 10.1093/bioinformatics/btv421. View

15.

Dahl K, Lundblad E, Rokenes T, Olsvik O, Sundsfjord A . Genetic linkage of the vanB2 gene cluster to Tn5382 in vancomycin-resistant enterococci and characterization of two novel insertion sequences. Microbiology (Reading). 2000; 146 ( Pt 6):1469-1479. DOI: 10.1099/00221287-146-6-1469. View

16.

Kawalec M, Gniadkowski M, Hryniewicz W . Outbreak of vancomycin-resistant enterococci in a hospital in Gdask, Poland, due to horizontal transfer of different Tn1546-like transposon variants and clonal spread of several strains. J Clin Microbiol. 2000; 38(9):3317-22. PMC: 87380. DOI: 10.1128/JCM.38.9.3317-3322.2000. View

17.

Barton B, Harding G, Zuccarelli A . A general method for detecting and sizing large plasmids. Anal Biochem. 1995; 226(2):235-40. DOI: 10.1006/abio.1995.1220. View

18.

Stamatakis A . RAxML version 8: a tool for phylogenetic analysis and post-analysis of large phylogenies. Bioinformatics. 2014; 30(9):1312-3. PMC: 3998144. DOI: 10.1093/bioinformatics/btu033. View

19.

Freitas A, Novais C, Tedim A, Francia M, Baquero F, Peixe L . Microevolutionary events involving narrow host plasmids influences local fixation of vancomycin-resistance in Enterococcus populations. PLoS One. 2013; 8(3):e60589. PMC: 3612099. DOI: 10.1371/journal.pone.0060589. View

20.

Gawryszewska I, Zabicka D, Hryniewicz W, Sadowy E . Penicillin-Resistant, Ampicillin-Susceptible in Polish Hospitals. Microb Drug Resist. 2020; 27(3):291-300. DOI: 10.1089/mdr.2019.0504. View