Affiliation:
1. National Research Center for Hematology (Moscow, Russia)
Abstract
Objective.
To study the genetic diversity of vancomycin-resistant Enterococcus faecium (VR-E. faecium) isolated from the blood culture in patients with hematological malignancies by multilocus sequence typing (MLST).
Materials and Methods.
VR-E. faecium isolated from the blood culture in hematological patients in 6 hospitals of 4 Russian cities (2003–2019) were evaluated. Susceptibility to vancomycin was tested by the broth microdilution method (CLSI, 2018). Vancomycin-resistance genes (vanA, vanB) were identified by polymerase chain reaction. Genotyping of VR-E. faecium was performed by MLST.
Results.
A total of 83 VR-E. faecium were examined. The vanA genes were detected in 71.1% (n = 59) VR-E. faecium, vanB genes – in 28.9% (n = 24). A total of 22 sequence types (STs) belonging to epidemic clonal complex CC17 were detected. The dominant sequence types were ST17 (19.3%), ST78 (18.1%), ST80 (16.9%), and comprised 54.3% VR-E. faecium. Other sequence types included 1 to 4 strains. VR-E. faecium carrying vanA, in comparison with VR-E. faecium vanB, significantly more often belonged to ST78 (23.7% vs. 4.2%, p = 0.0559, respectively) and ST80 (23.7% versus 0%, p = 0.0079, respectively) and less frequently to ST17 (6,8% versus 50%, р < 0.0001). Circulation of 9 STs including «high-risk» clones ST17 and ST78 was detected during two study periods (2003–2011 and 2012–2019).
Conclusions.
This study showed a genetic diversity of VR-E. faecium that was represented by 22 STs. All VR-E. faecium belonged to epidemic clonal complex CC17 and comprised «high-risk» clones ST17, ST78 and less common STs.
Publisher
Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy
Subject
Pharmacology (medical),Infectious Diseases,Microbiology (medical),Epidemiology
Reference39 articles.
1. Klyasova G.А., Okhmat V.А. Antimicrobial therapy. In: Savchenko V.G., ed. Algorithms of diagnosing and protocols of treatment of blood system diseases. Moscow: Praktika; 2018. P. 1069-1113. Russian.
2. Klyasova G.A., Fedorova A.V., Frolova I.N., Khrulnova S.A., Vetokhina A.V., Kaporskaya T.S., et al. Antimicrobial resistance of nosocomial Enterococcus spp. isolated from blood culture in patients with hematological malignancies. Klinicheskaja mikrobiologija i antimikrobnaja himioterapija. 2018;20(2):142-149. Russian. DOI: 10.36488/cmac.2018.2.142-149
3. European Centre for Disease Prevention and Control. Surveillance of antimicrobial resistance in Europe 2018. Stockholm: ECDC; 2019. Available at: www.ecdc.europa.eu/en/publications-data/surveillance-antimicrobialresistanceeurope-2018. Accessed March, 2021.
4. Weiner-Lastinger L., Abner S., Edwards J., Kallen A., Karlsson M., Magill S., et al. Antimicrobial-resistant pathogens associated with adult healthcare-associated infections: Summary of data reported to the National Healthcare Safety Network, 2015-2017. Infect Control Hosp Epidemiol. 2020;41(1):1-18. DOI: 10.1017/ice.2019.296
5. Coombs G.W., Daley D.A., Mowlaboccus S., Lee Y.T., Pang S., and Australian Group on Antimicrobial Resistance. Australian Group on Antimicrobial Resistance (AGAR) Australian Enterococcal Sepsis Outcome Programme (AESOP) Annual Report 2018. Commun Dis Intell. 2020;44. DOI: 10.33321/cdi.2020.44.19