ArticleAntimicrobial agents and chemotherapy2005
Population structure of Enterococcus faecium causing bacteremia in a Spanish university hospital: setting the scene for a future increase in vancomycin resistance?
Article in Antimicrobial agents and chemotherapy, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
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30 citing papers in PubMed, 94 citations in OpenAlex.
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- Diversity and Evolution of the Tn5801-tet(M)-Like Integrative and Conjugative Elements among Enterococcus, Streptococcus, and Staphylococcus.Antimicrobial agents and chemotherapy · 2016Article
- Molecular Analysis of Vancomycin-Resistant Enterococci Isolated from Regional Hospitals in Trinidad and Tobago.Advances in medicine · 2016Article
- Population biology of intestinal enterococcus isolates from hospitalized and nonhospitalized individuals in different age groups.Applied and environmental microbiology · 2015Article
- Algorithm for pre-emptive glycopeptide treatment in patients with haematologic malignancies and an Enterococcus faecium bloodstream infection.Antimicrobial resistance and infection control · 2013Article
- Genetic variability of vancomycin-resistant Enterococcus faecium and Enterococcus faecalis isolates from humans, chickens, and pigs in Malaysia.Applied and environmental microbiology · 2013Article
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- Recent recombination events in the core genome are associated with adaptive evolution in Enterococcus faecium.Genome biology and evolution · 2013Article
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- Genomic diversification of enterococci in hosts: the role of the mobilome.Frontiers in microbiology · 2012Article
- Population biology of Gram-positive pathogens: high-risk clones for dissemination of antibiotic resistance.FEMS microbiology reviews · 2011Review
- Human and swine hosts share vancomycin-resistant Enterococcus faecium CC17 and CC5 and Enterococcus faecalis CC2 clonal clusters harboring Tn1546 on indistinguishable plasmids.Journal of clinical microbiology · 2011Article
- Characterization of vancomycin-resistant Enterococcus faecium isolated from swine in three Michigan counties.Journal of clinical microbiology · 2010Article
- Global spread of the hyl(Efm) colonization-virulence gene in megaplasmids of the Enterococcus faecium CC17 polyclonal subcluster.Antimicrobial agents and chemotherapy · 2010Article
- A potential role for daptomycin in enterococcal infections: what is the evidence?The Journal of antimicrobial chemotherapy · 2010Review
- Dispersion of multidrug-resistant Enterococcus faecium isolates belonging to major clonal complexes in different Portuguese settings.Applied and environmental microbiology · 2009Article
- Dogs are a reservoir of ampicillin-resistant Enterococcus faecium lineages associated with human infections.Applied and environmental microbiology · 2009Article
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Authors and funding
8 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Over an 8-year period (1995 to 2002), 86 Enterococcus faecium blood isolates from 84 patients, of which 54 were ampicillin resistant (AREF) and 32 were ampicillin susceptible (ASEF), were studied in a university hospital (1,200 beds; serving a population of 600,000) in Spain, a country characterized by a near-absence of resistance to vancomycin and very high rates of ampicillin resistance among enterococci. Clonal relatedness by pulsed-field gel electrophoresis (PFGE), antibiotic susceptibility, presence of the virulence/epidemicity genes esp(Efm) and hyl(Efm), and identification of purK alleles were studied. A group of isolates was also analyzed by amplified fragment length polymorphism (AFLP) and multilocus sequence typing. Medical charts (30 variables collected) were reviewed for 60/84 patients. ASEF showed high clonal diversity (32 PFGE types, 11 purK alleles, 4 AFLP genogroups), did not harbor putative virulence genes, and had no specific association with hospital acquisition. AREF isolates belonged to a clonal complex (CC) of genetically related strains (purK-1, AFLP genogroup C), occasionally harboring putative virulence traits, and were from patients with particular risk factors. Within this CC, previously associated with vancomycin-resistant E. faecium isolates causing outbreaks worldwide (W. L. Homan et al., J. Clin. Microbiol. 40:1963-1971, 2002), a great genetic diversity of antibiotic resistance and virulence/epidemicity profiles was found. Associations between esp and a >7-day hospital stay and between purK-1, hospital location, and nosocomial acquisition were noted (P < 0.001). These findings reflect the importance of local environmental differences in the evolution of this CC, suggesting that the emergence of vancomycin resistance among AREF strains in Spain may be a question of time.
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