Comparison of Enterococcus faecium Bacteremic Isolates from Hematologic and Non-hematologic Patients: Differences in Antimicrobial Resistance and Molecular Characteristics
Annals of Laboratory Medicine
;
: 226-234, 2018.
Article
in English
| WPRIM
| ID: wpr-714434
ABSTRACT
BACKGROUND:
Enterococcus faecium, especially vancomycin-resistant E. faecium (VREfm), is a major concern for patients with hematologic diseases. Exposure to antibiotics including fluoroquinolone, which is used as a routine prophylaxis for patients with hematologic (MH) diseases, has been reported to be a risk factor for infection with vancomycin-resistant eneterocci. We compared the characteristics of E. faecium isolates according to their vancomycin susceptibility and patient group (MH vs non-MH patients).METHODS:
A total of 120 E. faecium bacteremic isolates (84 from MH and 36 from non-MH patients) were collected consecutively, and their characteristics (susceptibility, multilocus sequence type [MLST], Tn1546 type, and the presence of virulence genes and plasmids) were determined.RESULTS:
Among the vancomycin-susceptible E. faecium (VSEfm) isolates, resistance to ampicillin (97.6% vs 61.1%) and high-level gentamicin (71.4% vs 38.9%) was significantly higher in isolates from MH patients than in those from non-MH patients. Notably, hyl, esp, and pEF1071 were present only in isolates with ampicillin resistance. Among the VREfm isolates, ST230 (33.3%) and ST17 (26.2%) were predominant in MH patients, while ST17 (61.1%) was predominant in non-MH patients. Plasmid pLG1 was more prevalent in E. faecium isolates from MH patients than in those from non-MH patients, regardless of vancomycin resistance. Transposon analysis revealed five types across all VREfm isolates.CONCLUSIONS:
The antimicrobial resistance profiles and molecular characteristics of E. faecium isolates differed according to the underlying diseases of patients within the same hospital. We hypothesize that the prophylactic use of fluoroquinolone might have an effect on these differences.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Plasmids
/
Virulence
/
Ampicillin Resistance
/
Gentamicins
/
Vancomycin
/
Risk Factors
/
Enterococcus faecium
/
Enterococcus
/
Vancomycin Resistance
/
Multilocus Sequence Typing
Type of study:
Etiology study
/
Risk factors
Limits:
Humans
Language:
English
Journal:
Annals of Laboratory Medicine
Year:
2018
Type:
Article
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