ABSTRACT
Vancomycin-resistant enterococci (VRE) are nosocomial pathogens of increasing medical importance. This study involved 121 VRE selectively obtained from a representative set of 1464 samples collected from various sources in the north-eastern part of the Czech Republic. In total, 119 VRE belonged to Enterococcus faecium and two to Enterococcus faecalis. All isolates of E. faecium were resistant to at least three antibiotic classes. The resistance genes vanA, erm(B), tet(M), tet(L), aac(3)-IIIa and aac(6')-aph(2'') were detected. We assigned the E. faecium to sequence types ST5, ST18, ST38, ST64, ST92, ST273, ST549 and ST640. In E. faecium isolates, we identified the presence of replicases rep20p LG 1 , rep2p RE 25 , rep17p RUM , rep21p VEF 1/2 and rep14p RI 1 , as well as relaxases relp EF 1 , relp LG 1 , relp CIZ 2 , relp RE 25 and relp RUM . The presence of the toxin-antitoxin system axe-txe was detected mainly among isolates of hospital origin. The A and D types of transposon Tn1546 were those occurring most frequently. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first extensive study of vancomycin-resistant enterococci of diverse origin in a single well-defined area of the Czech Republic. The isolates were investigated for their antibiotic resistance, epidemiological characteristics and plasmid characteristics. Based on the results obtained, we can make assumptions as to the ways that vancomycin resistance is disseminated throughout the environment including humans and animals.
Subject(s)
Enterococcus faecalis/drug effects , Enterococcus faecium/drug effects , Gram-Positive Bacterial Infections/epidemiology , Vancomycin Resistance/genetics , Vancomycin-Resistant Enterococci/genetics , Vancomycin-Resistant Enterococci/isolation & purification , Animals , Anti-Bacterial Agents/pharmacology , Bacterial Proteins/genetics , Czech Republic , Enterococcus faecalis/genetics , Enterococcus faecalis/isolation & purification , Enterococcus faecium/genetics , Enterococcus faecium/isolation & purification , Gram-Positive Bacterial Infections/microbiology , Humans , Plasmids/genetics , Toxin-Antitoxin Systems/genetics , Vancomycin-Resistant Enterococci/classificationSubject(s)
Antibodies, Viral/analysis , Blood Proteins/analysis , Immunoglobulins/analysis , Influenza, Human/immunology , C-Reactive Protein/analysis , Ceruloplasmin/analysis , Child , Convalescence , Czechoslovakia , Disease Outbreaks , Hemagglutination Inhibition Tests , Humans , Immunodiffusion , Immunoglobulin A/analysis , Immunoglobulin D/analysis , Immunoglobulin G/analysis , Immunoglobulin M/analysis , Influenza, Human/blood , Macroglobulins/analysis , Orthomyxoviridae/immunology , Transferrin/analysisABSTRACT
As part of an investigation on tick-borne encephalitis in the Tribec region of Czechoslovakia, an epidemiological study has been carried out on 445 cases diagnosed as "virus meningo-encephalitis" over the period 1953-63. The average morbidity rate was 19.3 per 100 000 inhabitants, ranging from 107.9 in 1955 to 3.3 in 1961. The lowest morbidity rates were in the 0-4 years and 60+years age-groups (5.7 and 5.5, respectively) and the highest rate was in the 10-14 years age-group (33.2). When the figures for 1960-63 were analysed, the highest rate (21.3) was found among adult farmers and forestry workers. The morbidity rates in the Tribec region are, on average, 2.6 times those for Czechoslovakia as a whole and 4.7 times those for Slovakia. There is a seasonal variation in incidence, with a maximum in June.The most frequent method of infection was by tick bite. Villages in the south-east of the region had a higher incidence of disease than those in the north-west. Serological examinations revealed variations in activity within the focus: whereas, of 93 inhabitants of four villages who had suffered from "virus meningo-encephalitis", 63 (68%) had antibodies against tick-borne encephalitis virus, none of 95 randomly selected inhabitants of a village with no reported cases of the disease had antibodies. More accurate diagnosis of the disease has been achieved by the introduction of serological and cultivation procedures.
