Molecular analysis and distribution of multidrug-resistant Enterococcus faecium isolates belonging to clonal complex 17 in a tertiary care center in Mexico City

BMC Microbiology

Juan Xicohtencatl-Cortes¹  Guillermo Aquino-Jarquin²  Rigoberto Hernández-Castro³  Briceida López-Martínez⁴  Carlos A Eslava⁵  Vicenta Cázares-Domímguez¹  Zeus Saldaña¹  Leticia B Dávila¹  Ariadnna Cruz-Córdova¹  Gerardo Escalona¹  Sara A Ochoa¹ 

[1] Departamento de Infectología, Laboratorio de Bacteriología Intestinal, Hospital Infantil de México Federico Gómez, México City, DF 06720, México;Unidad de Investigación en Enfermedades Oncológicas, Hospital Infantil de México Federico Gómez, Dr. Márquez 162, Col. Doctores, Delegación Cuauhtémoc, México City, DF 06720, México;Departamento de Ecología de Agentes Patógenos, Hospital General “Dr. Manuel Gea González”, Tlalpan 14080, México;Departamento Clínico, Hospital Infantil de México Federico Gómez, México City, DF 06720, México;Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional Autónoma de México, Av. Insurgentes Sur s/n., México City, DF 04510, México

关键词: Virulence;    Pulsotypes;    Clonal complex;    Multidrug-resistant;    Enterococcus faecium;   

Others  :  1142407
DOI  :  10.1186/1471-2180-13-291

 received in 2013-09-12, accepted in 2013-12-02,  发布年份 2013

【 摘 要 】

Background

Enterococcus faecium has recently emerged as a multidrug-resistant nosocomial pathogen involved in outbreaks worldwide. A high rate of resistance to different antibiotics has been associated with virulent clonal complex 17 isolates carrying the esp and hyl genes and the purK1 allele.

Results

Twelve clinical vancomycin-resistant Enterococcus faecium (VREF) isolates were obtained from pediatric patients at the Hospital Infantil de México Federico Gómez (HIMFG). Among these VREF isolates, 58.3% (7/12) were recovered from urine, while 41.7% (5/12) were recovered from the bloodstream. The VREF isolates showed a 100% rate of resistance to ampicillin, amoxicillin-clavulanate, ciprofloxacin, clindamycin, chloramphenicol, streptomycin, gentamicin, rifampicin, erythromycin and teicoplanin. In addition, 16.7% (2/12) of the isolates were resistant to linezolid, and 66.7% (8/12) were resistant to tetracycline and doxycycline. PCR analysis revealed the presence of the vanA gene in all 12 VREF isolates, esp in 83.3% (10/12) of the isolates and hyl in 50% (6/12) of the isolates. Phylogenetic analysis via molecular typing was performed using pulsed-field gel electrophoresis (PFGE) and demonstrated 44% similarity among the VREF isolates. MLST analysis identified four different sequence types (ST412, ST757, ST203 and ST612).

Conclusion

This study provides the first report of multidrug-resistant VREF isolates belonging to clonal complex 17 from a tertiary care center in Mexico City. Multidrug resistance and genetic determinants of virulence confer advantages among VREF in the colonization of their host. Therefore, the prevention and control of the spread of nosocomial infections caused by VREF is crucial for identifying new emergent subclones that could be challenging to treat in subsequent years.

【 授权许可】

   
2013 Ochoa et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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