vanA-containing E. faecium isolates of clonal complex CC17 in clinical and environmental samples in a Tunisian hospital

  1. Elhani, D. 3
  2. Klibi, N. 4
  3. Dziri, R. 4
  4. Ben Hassan, M. 2
  5. Asli Mohamed, S. 2
  6. Ben Said, L. 4
  7. Mahjoub, A. 3
  8. Ben Slama, K. 4
  9. Jemli, B. 2
  10. Bellaj, R. 5
  11. Barguellil, F. 2
  12. Torres, C. 1
  1. 1 Universidad de La Rioja
    info

    Universidad de La Rioja

    Logroño, España

    ROR https://ror.org/0553yr311

  2. 2 Military Hospital of Tunis
    info

    Military Hospital of Tunis

    Túnez, Túnez

    ROR https://ror.org/04n4f3r80

  3. 3 University of Monastir
    info

    University of Monastir

    Monastir, Túnez

    ROR https://ror.org/00nhtcg76

  4. 4 Université de Tunis El Manar
    info

    Université de Tunis El Manar

    Túnez, Túnez

    ROR https://ror.org/029cgt552

  5. 5 Service d'hygiène hospitalière et de protection de l'environnement, HMPIT, Tunis, Tunisia
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Revista:
Diagnostic Microbiology and Infectious Disease

ISSN: 0732-8893

Año de publicación: 2014

Volumen: 79

Número: 1

Páginas: 60-63

Tipo: Artículo

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DOI: 10.1016/J.DIAGMICROBIO.2014.01.011 SCOPUS: 2-s2.0-84898449766 WoS: WOS:000335093300012 GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Diagnostic Microbiology and Infectious Disease

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2013/00001/001

Resumen

Twenty-eight vancomycin (VA)-resistant enterococci isolated from different patients (n = 16) and also from the environment (n = 12) were recovered in a Tunisian military hospital during 2012-2013. The mechanisms of resistance to VA and to other antibiotics as well as the presence of esp and hyl virulence genes were determined in these isolates by PCR, being their clonal relationship analyzed by pulsed-field gel electrophoresis (PFGE). VA resistance mechanisms detected were as follows (species-patient/environment): vanA (Enterococcus faecium, 13/5), vanC1 (Enterococcus gallinarum, 3/0), and vanC2 (Enterococcus casseliflavus, 0/7). Most of the VA-resistant enterococci presented a multiresistance phenotype and harbored different resistance genes (erm(B), tet(M), tet(L), ant(6)-Ia, aac(6')-aph(2"), aph(3')-IIIa, and catA). The PFGE revealed the presence of 3 clones (A, B, C) and 1 closely related pattern (A1) among the 13 vanA-containing E. faecium isolates of patients showing 11 of them the A-A1 patterns. The clone A was also detected in all 5 environmental vanA-containing E. faecium isolates. Strains did not contain esp or hyl virulence genes. Multilocus sequence typing was performed in 4 E. faecium isolates representative of the 4 detected pulsotypes (A, A1, B, and C), and 2 different sequence types were identified (ST18 and ST80), both of them included in clonal complex CC17. These strains contained the IS16 element and showed ampicillin and ciprofloxacin resistance. VA resistance could be an emerging problem in Tunisia, and this is one of the first cases described so far in this country