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首页> 外文期刊>Journal of Clinical Microbiology >Clonal Spread of a Vancomycin-Resistant Enterococcus faecium Strain among Bloodstream-Infecting Isolates in Italy
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Clonal Spread of a Vancomycin-Resistant Enterococcus faecium Strain among Bloodstream-Infecting Isolates in Italy

机译：耐万古霉素肠球菌粪便菌株在意大利血流感染分离株中的克隆传播

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Recent data indicated that the rate of vancomycin resistance in bloodstream-infecting enterococcal isolates in Italy is one of the highest in Europe. The aims of this study were to characterize bloodstream-infecting vancomycin-resistant enterococci (VRE) obtained from various Italian hospitals and to establish whether the isolates were clonally related. During the years 2001 to 2003, a total of 39 VRE isolates were obtained from 19 hospital laboratories in various areas of Italy. Species identification and resistance genotypes of the isolates were obtained by multiplex PCR. Further characterization included antibiotic susceptibility testing, pulsed-field gel electrophoresis (PFGE) of SmaI-digested genomic DNA, detection of virulence genes (esp and hyl), and multilocus sequence typing (MLST) of selected isolates. VRE were identified as 31 Enterococcus faecium (VREfm) isolates and 8 E. faecalis isolates. All but one isolate carried the vanA gene; one VREfm isolate carried the vanB gene. Analysis of the PFGE profiles showed that 28 VREfm isolates shared a similar electrophoretic profile, designed type 1, and were clonally related. All type 1 isolates were resistant to ampicillin, streptomycin, gentamicin, and rifampin and were positive for the esp gene. MLST identified an allelic profile (ST78) comprising purK allele 1, belonging to the C1 clonal lineage, characteristic of human infection and hospital outbreak isolates. The vanB-carrying VREfm isolate, of PFGE type 2, was shown to be a single-locus variant of ST78. Our data indicate that the recent increase in the number of bloodstream infections caused by VRE in Italy is due to the spread of a hospital-adapted, multidrug-resistant VREfm clone belonging to an internationally disseminated lineage.
机译：最近的数据表明，意大利血液感染肠球菌分离株对万古霉素的耐药率是欧洲最高的。这项研究的目的是表征从意大利多家医院获得的血液感染万古霉素耐药肠球菌（VRE）的特征，并确定分离株是否具有克隆关系。在2001年至2003年期间，从意大利各个地区的19个医院实验室获得了39株VRE分离株。通过多重PCR获得分离物的物种鉴定和抗性基因型。进一步的表征包括抗生素敏感性测试，SmaI消化的基因组DNA的脉冲场凝胶电泳（PFGE），毒力基因（ esp 和 hyl ）的检测以及多基因座序列分型（MLST）的选定菌株。 VRE被鉴定为31株肠球菌（VREfm）分离株和8株 E。粪便分离株。除一个分离株外，所有分离株都带有 vanA 基因。一个VREfm分离株带有 vanB 基因。 PFGE图谱的分析表明，28个VREfm分离株具有相似的电泳图谱，设计为1型，并且具有克隆相关性。所有1型分离株均对氨苄西林，链霉素，庆大霉素和利福平具有抗性，并且对 esp 基因呈阳性。 MLST鉴定了一个等位基因谱（ST78），其中包含 purK 等位基因1，属于C1克隆谱系，具有人类感染和医院暴发分离株的特征。携带2个PFGE类型的 vanB 的VREfm分离株是ST78的单基因座变异体。我们的数据表明，最近在意大利由VRE引起的血流感染数量增加是由于属于医院的，耐多药的VREfm克隆的传播，该克隆属于国际传播的血统。

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