COQUE TM, WILLEMS RJ, FORTUN J, TOP J, DIZ S, CANTON R, LOZA E, BAQUERO F; Interscience Conference on Antimicrobial Agents and Chemotherapy (43rd: 2003: Chicago, Ill.).

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2003 Sep 14-17; 43: abstract no. K-1111.

Hospital Ramon y Cajal, Madrid, Spain.

BACKGROUND: E. faecium (Efm) has become a relevant nosocomial pathogen due to acquisition of antibiotic resistances. esp[Efm] and hyl[Efm], seem to play a role in the epidemicity and/or virulence of Efm. METHODS: We studied 88 blood Efm isolates from 86 patients (1995-2002) in our hospital located in a country with low VRE rate. Clonality by PFGE, antibiotic susceptibility, presence of esp[Efm] and hyl[Efm] by PCR were studied. A group of isolates was analyzed by AFLP and MLST. Patient's medical charts were review (30 variables). RESULTS: Fifty-four (61%) isolates were Ap[R] and 34 (39%) were Ap[S] classified in 27 and 34 PFGE types, respectively. Ap[R] were more resistant to antibiotics than Ap[S] Efm: Ery (100/41%), Cipro (80/24%), HLRSm (78/15%) and HLRGm (11/0%). 2/88 (2%) were VRE. All Efm Ap[R] belong to AFLP group C (related to hospitalized hosts). Efm Ap[S] were distributed among A, B (related to poultry/porcine hosts), C and R (non-classified) ecovars, suggesting different acquisition sources for Ap[R] and Ap[S] Efm. We found esp[Efm ]or hyl[Efm] in 24/88 (27%) and 8/88 (9%) isolates (all Ap[R] and AFLP group C). Only 3/88 isolates (4%) from 3 clones had both esp[Efm] and hyl[Efm]. Isolates with/without Esp or Hyl were found within specific clonal types. In these cases, the Esp(-) or Hyl(-) isolates preceded in time to the positive ones suggesting hospital acquisition of the traits. Significant association between presence of esp and >7days-hospital stay or urinary catherization was proved. Within homogeneous Ap[R] C1-ST18 MLST cluster, Esp-Hyl-, Esp+Hyl-, and Esp-Hyl+ variants of different PFGE types were found. CONCLUSIONS: The results suggest that we might be attending to the first evolutionary steps converting organisms from C1 MLST cluster in efficient hospital colonizers, eventually involved in future outbreaks.

Publication Types:

• Meeting Abstracts

Keywords:

• Anti-Bacterial Agents
• Bacteremia
• Drug Resistance
• Electrophoresis, Gel, Pulsed-Field
• Enterococcus faecium
• Evolution
• Humans
• Virulence
• Virulence Factors
• genetics

Other ID:

• GWAIDS0026458

UI: 102266082

From Meeting Abstracts