Vancomycin-dependent Enterococcus faecium vanA: characterization of the first case isolated in a university hospital in Brazil

In this study, we report the characterization of a strain of Enterococcus faecium vanA, which grows only in the presence of vancomycin (VDEfm-UEL). The bacterium was isolated from the feces of a female patient who had undergone surgical treatment of Reinke's edema and was receiving intravenous...

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Bibliographic Details
Published in:Brazilian journal of medical and biological research 2011-03, Vol.44 (3), p.253-257
Main Authors: Kerbauy, G, Perugini, M R E, Yamauchi, L M, Yamada-Ogatta, S F
Format: Article
Language:English
Subjects:
Aged
Anti-Bacterial Agents - pharmacology
BIOLOGY
Cross Infection - microbiology
Dependence
Drug Resistance, Multiple, Bacterial - drug effects
Enterococcus faecium
Enterococcus faecium - drug effects
Enterococcus faecium - genetics
Enterococcus faecium - isolation & purification
Feces - microbiology
Female
Frameshift Mutation - genetics
Hospitals, University
Humans
MEDICINE, RESEARCH & EXPERIMENTAL
Methicillin-Resistant Staphylococcus aureus - drug effects
Microbial Sensitivity Tests
Polymerase Chain Reaction
Staphylococcus aureus
vanA genotype
Vancomycin
Vancomycin Resistance - genetics
Virulence factors
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Summary:In this study, we report the characterization of a strain of Enterococcus faecium vanA, which grows only in the presence of vancomycin (VDEfm-UEL). The bacterium was isolated from the feces of a female patient who had undergone surgical treatment of Reinke's edema and was receiving intravenous vancomycin therapy for infection with methicillin/oxacillin-resistant Staphylococcus aureus, a postoperative complication. Antimicrobial dependence was further confirmed by the vancomycin E-test. VDEfm-UEL was also shown to be resistant to ampicillin, ciprofloxacin, chloramphenicol, erythromycin, levofloxacin, penicillin, rifampicin, and teicoplanin. The putative virulence genes efaA, gelE and esp were detected by PCR. The ddl gene from VDEfm-UEL was cloned and sequenced. Vancomycin dependence seems to be associated with the insertion of a nucleotide in that sequence, which results in a frame-shift mutation, introducing a premature stop codon. This is the first report of vancomycin-dependent E. faecium isolation in a university hospital in Brazil.
ISSN:0100-879X
1414-431X
1414-431X
0100-879X
DOI:10.1590/S0100-879X2011007500006