Appearance of vanD-positive Enterococcus faecium in a tertiary hospital in the Netherlands: prevalence of vanC and vanD in hospitalized patients

Abstract Vancomycin-resistant enterococci (VRE) can rapidly spread through hospitals. Therefore, our hospital employs a screening program whereby rectal swabs are screened for the presence of vanA and vanB , and only PCR-positive broths are cultured on VRE selection agar. Early November 2016, a clinical vanA- / vanB -negative VRE isolate was detected in a vanA/vanB -screening-negative patient, giving the possibility that an undetected VRE might be spreading within our hospital. Whole-genome-sequencing of the isolate showed that resistance was vanD -mediated and core genome multilocus sequence... Mehr ...

Verfasser: Flipse, Jacky
von Wintersdorff, Christian J. H.
van Niekerk, Julius M.
Jamin, Casper
van Tiel, Frank H.
Hasman, Henrik
van Alphen, Lieke B.
Dokumenttyp: Artikel
Erscheinungsdatum: 2019
Reihe/Periodikum: Scientific Reports ; volume 9, issue 1 ; ISSN 2045-2322
Verlag/Hrsg.: Springer Science and Business Media LLC
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29220308
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : http://dx.doi.org/10.1038/s41598-019-42824-4

Abstract Vancomycin-resistant enterococci (VRE) can rapidly spread through hospitals. Therefore, our hospital employs a screening program whereby rectal swabs are screened for the presence of vanA and vanB , and only PCR-positive broths are cultured on VRE selection agar. Early November 2016, a clinical vanA- / vanB -negative VRE isolate was detected in a vanA/vanB -screening-negative patient, giving the possibility that an undetected VRE might be spreading within our hospital. Whole-genome-sequencing of the isolate showed that resistance was vanD -mediated and core genome multilocus sequence typing showed it was a rare type: ST17/CT154. To determine the prevalence of vanA/B/C/D -carrying enterococci, we designed a real-time PCR for vanC1/2/3 and vanD and screened rectal swabs from 360 patients. vanD was found in 27.8% of the patients, yet culture demonstrated only E . faecium from vanA -positive broths and E . gallinarum from vanC1 -positive broths. No vanD -positive VRE were found, limiting the possibility of nosocomial spread of this VRE. Moreover, the high prevalence of non-VRE vanD in rectal swabs makes it unfeasible to include the vanD PCR in our VRE screening. However, having validated the vanC1/2/3 and vanD PCRs allows us to rapidly check future vanA/B -negative VRE for the presence of vanC and vanD genes.