Details

Autor(en) / Beteiligte

• do Prado, Gladys Villas Boas
• Marchi, Ana Paula
• Moreno, Luisa Zanolli
• Rizek, Camila
• Amigo, Ulisses
• Moreno, Andrea Micke
• Rossi, Flavia
• Guimaraes, Thais
• Levin, Anna Sara
• Costa, Silvia F.

Titel

Virulence and resistance pattern of a novel sequence type of linezolid-resistant Enterococcus faecium identified by whole-genome sequencing

Ist Teil von

• Journal of global antimicrobial resistance., 2016-09, Vol.6, p.27-31

Ort / Verlag

Netherlands: Elsevier Ltd

Erscheinungsjahr

2016

Link zum Volltext

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• •We evaluated a vancomycin-resistant Enterococcus faecium (VREfm) resistant to linezolid isolated in a HSCT patient previously colonised by VREfm and the incidence of VREfm colonisation/infection in a bone marrow transplant unit over 10 years.•E. faecium was predominant during the study period, and all isolates harboured the vanA gene.•Four major clusters were identified, however, the linezolid-resistant VREfm had only 50% similarity and differed from the isolate that previously colonised the patient.•All sequence types (STs) identified belonged to complex clonal 17, and the linezolid-resistant VRE belonged to a novel ST (ST987).•The predominant clone was more virulent than the linezolid-resistant clone. Empirical use of linezolid has been advocated in neutropenic febrile patients colonised by vancomycin-resistant enterococci (VRE) because of the risk of bloodstream infection (BSI). This study aimed to genetically describe a vancomycin-resistant Enterococcus faecium (VREfm) BSI isolate resistant to linezolid (VRLRE) in a patient previously colonised by VREfm and to determine the incidence of colonisation and infection by VREfm in a bone marrow transplant unit over a 10-year period. Data for VREfm colonisation and infection were evaluated. PCR for the vanA and vanB genes, pulsed-field gel electrophoresis (PFGE) and microdilution antimicrobial susceptibility testing (vancomycin, teicoplanin, linezolid and aminoglycosides) were performed. Three isolates, including the VRLRE, were selected for whole-genome sequencing by Ion Torrent™, with E. faecium CP006620-Aus0085 used as a reference. Eighty-seven VREfm were analysed; all were linezolid-susceptible and harboured vanA, except for one blood isolate from a febrile neutropenic patient colonised by VREfm who received linezolid for 12 days and developed a BSI by VRLRE (linezolid MIC≥8μg/mL). Linezolid resistance was associated with a G2576T mutation in the 23SrRNA gene. PFGE analysis demonstrated that the 87 isolates belonged to four major clusters; however, the VRLRE presented only 50% similarity. Three sequence types (STs) were identified: ST412 (the predominant clone, which was more virulent compared with the other isolates); ST478 (linezolid-susceptible VREfm); and a novel ST named ST987 (VRLRE). SNP analysis showed a higher similarity between linezolid-susceptible VREfm and the predominant clone compared with VRLRE. VRLRE presented a G2576T mutation and belonged to a novel ST (ST987).