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Characterization of vanA vancomycin-resistant enterococci isolated from humans and animals in Taiwan

Characterization of vanA vancomycin-resistant enterococci isolated from humans and animals in Taiwan

Abstracts of the General Meeting of the American Society for Microbiology 103: C-412

Fifty-four vancomycin-resistant enterococci (VRE) harboring the vanA gene collected from patients in eight different hospitals were studied. These isolates included 27 Enterococcus faecalis and 27 E. faecium. Nine of 27 E. faecalis isolates were highly resistant to both vancomycin and teicoplanin and were classified as typical VanA VRE. The remaining 18 E. faecalis isolates were resistant to vancomycin but susceptible to teicoplanin and were considered as vanA-containing VRE with a VanB phenotype. Eleven of the 27 vanA-containing E. faecium isolates also had the VanB phenotype; therefore, 54% of these human vanA VRE isolates had the VanB phenotype. Twelve E. faecalis isolates from chicken feather and 21 VRE (14 E. faecalis and 7 E. faecium) isolates from poultry meat were also studied. All of these isolates also harbored the vanA gene, and 23 of them had the VanB phenotype. All the vanA VRE with a VanB phenotypes were found to have amino acid substitutions at 3 positions in the N-terminal region of the vanS gene. A total of 21 different PFGE types (designated 1 through 21) were found in the 27 human vanA-containing E. faecalis isolates, and 8 different PFGE types (designated a through h) were found in the 27 E. faecium isolates from humans. Among these, type a was found only in Hospital A and type c was found only in Hospital C. These observations suggest that nosocomial infections by these two types of VRE occurred in these two hospitals. The VanA resistance gene elements of these isolates were also examined, and four structurally distinct VanA elements were found in the 54 vanA VRE isolates from humans. The Group A VanA element was found to be the most common type in both human (70%, 38/54) and nonhuman (95%, 37/39) isolates. Two novel VanA elements (designated Groups Y and Z) were found in the human isolates, and one novel VanA element (designated Group alpha) was found in the nonhuman isolates. These results suggest that the food chain could be a source of vanA VRE and a means of horizontal transfer of vancomycin resistance gene in enterococci in Taiwan.

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