BioMed Research International

Research Article

Molecular Analysis of VanA Outbreak of Enterococcus faecium in Two Warsaw Hospitals: The Importance of Mobile Genetic Elements

Table 2

Clonal relatedness, antimicrobial resistance profiles, and distribution of resistance and virulence determinants among IO and IH outbreak isolates.


Isolate	MT/PT/ST	MIC VAN (mg/L)	MIC TEI (mg/L)	Resistance phenotypes^a,b	Resistance determinants^b,c	Cotransferred resistance	Virulence genes	Pili genes^d

Institute of oncology
988	1/2-A/17	>256	32	RIF	ermB	ERY	—	fms17, fms5, fms19
989*	159/3/78	>256	256	CHL, GEN, KAN, RIF	aac(6′)-Ie-aph(2′′)-Ia, cat, tetM	—	esp, hyl	fms5, fms19
990	1/4-A/18	>256	32	RIF	ermB, tetM	ERY	hyl	fms5, fms19
991	3/1-A/18	>256	32	RIF	ermB, tetM	ERY	hyl	fms5, fms19
992	3/1-A/nd	>256	32	RIF	ermB, tetM	ERY	hyl	fms5, fms19
993	3/1-A/nd	>256	32	RIF	ermB, tetM	ERY	hyl	fms5, fms19
994	3/1-A/nd	>256	32	RIF	ermB, tetM	ERY	hyl	fms5, fms19
995	3/1-A/nd	>256	24	RIF, TET	ermB, tetM	ERY	hyl	fms5, fms19
996	3/1-A/nd	>256	32	RIF, TET	ermB, tetM	ERY	hyl	fms5, fms19
3612	3/1-C/nd	>256	48	GEN, RIF, TET	ermB, tetM	ERY	hyl	fms5, fms19
3613	3/1-C/nd	>256	32	RIF, TET	ermB, tetM	ERY	hyl	fms5, fms19
3614	3/1-C/nd	>256	32	RIF, TET	ermB, tetM	ERY	hyl	fms5, fms19
3615	3/1-C/nd	>256	32	RIF, TET	ermB, tetM	ERY	hyl	fms5, fms19
3616	3/1-C/nd	>256	32	RIF, TET	ermB, tetM	ERY	hyl	fms5, fms19
3617	3/1-C/nd	>256	32	RIF, TET	ermB, tetM	ERY	hyl	fms5, fms19
3618	3/1-C/nd	>256	32	RIF, TET	ermB, tetM	ERY	hyl	fms5, fms19
3620	10/5/262	>256	48	GEN, KAN, RIF, STR, TET	aac(6′)-Ie-aph(2′′)-Ia, aad6, ermB, tetM	ERY	hyl	fms17, fms5, fms19
3621	3/1-C/nd	>256	32	RIF, TET	ermB, tetM	ERY	hyl	fms5, fms19
3622	3/1-B/18	>256	32	RIF, TET	ermB, tetM	ERY	hyl	fms5, fms19
3623	3/1-C/nd	>256	48	RIF, TET	ermB, tetM	ERY	hyl	fms5, fms19
3624	10/5/262	>256	48	GEN, KAN, RIF, STR, TET	aac(6′)-Ie-aph(2′′)-Ia, aad6, ermB, tetM	no	—	fms17, fms5, fms19
3625	10/5/nd	>256	48	GEN, KAN, RIF, STR, TET	aac(6′)-Ie-aph(2′′)-Ia, aad6, ermB, tetM	no	—	fms17, fms5, fms19
3626	10/5/nd	>256	48	GEN, KAN, RIF, STR, TET	aac(6′)-Ie-aph(2′′)-Ia, aad6, ermB, tetM	no	—	fms17, fms5, fms19
3627	10/5/nd	>256	48	GEN, KAN, RIF, STR, TET	aac(6′)-Ie-aph(2′′)-Ia, aad6, ermB, tetM	ERY	—	fms17, fms5, fms19
3628	3/1-C/nd	>256	64	RIF, TET	ermB, tetM	ERY	hyl	fms5, fms19
3629	7/2-B/18	>256	48	GEN, KAN, TET	aac(6′)-Ie-aph(2′′)-Ia, ermB, tetM	ERY	hyl	fms17, fms5, fms19
3630	10/5/nd	>256	64	GEN, KAN, RIF, STR, TET	aac(6′)-Ie-aph(2′′)-Ia, aad6, ermB, tetM	ERY, TET	—	fms17, fms5, fms19
IO ( = 27)				CHL (1), GEN (9), KAN (8), STR (6), TET (20), RIF (26)	*cat* (1), *aac(6′)-Ie-aph(2′′)-Ia* (8), *aad6, (6), ermB* (26), *tetM* (26)	ERY (23), TET (1)	*hyl* (21), *esp* (1)	*fms17* (8), *fms5* (27), *fms19* (27)

Institute of hematology
3549	11/7-A/202	>256	32	GEN, KAN, RIF, TET	aac(6′)-Ie-aph(2′′)-Ia, aph(2′′)-Ib, ermB, tetM	ERY, GEN	esp, hyl	fms17, fms5, fms19
3550^x	7/8/18	>256	48	GEN, KAN, RIF, STR	aac(6′)-Ie-aph(2′′)-Ia, aph(2′′)-Ib, aph(3′)-IIIa, aad6, ermB	ERY	esp, hyl	fms17, fms5, fms19
3551	159/9/78	>256	32	GEN, KAN, RIF, STR	aac(6′)-Ie-aph(2′′)-Ia, aph(2′′)-Ib, aph(3′)IIIa, aad6, ermB	ERY	esp, hyl	fms17, fms19
3552*	7/10/18	>256	>256	KAN, RIF, STR	aph(3′)-IIIa, aad6, ermB, tetM	ERY	esp, hyl	fms17, fms5, fms19
3553	11/7-A/nd	>256	32	GEN, KAN, RIF, TET	aac(6′)-Ie-aph(2′′)-Ia, aph(2′′)Ib, aph(3′)IIIa, ermB, tetM	ERY	esp, hyl	fms17, fms5, fms19
3554	159/6-A/192	>256	48	GEN, KAN, RIF, STR	aac(6′)-Ie-aph(2′′)-Ia, aph(2′′)-Ib, aph(3′)-IIIa, aad6, ermB	no	esp, hyl	fms17, fms5, fms19
3555	159/6-B/nd	>256	48	GEN, KAN, RIF, STR	aac(6′)-Ie-aph(2′′)-Ia, aph(2′′)-Ib, aph(3′)-IIIa, aad6, ermB	no	esp, hyl	fms17, fms5, fms19
3556	159/6-C/nd	>256	32	GEN, KAN, STR	aac(6′)-Ie-aph(2′′)-Ia, aph(3′)-IIIa, aad6, ermB	no	esp, hyl	fms17, fms5, fms19
3557^x#	296/11/17	>256	48	KAN, RIF	aph(3′)-IIIa, aad6, cat, ermB, tetM	ERY	esp, hyl	fms17, fms19
3558	159/6-A/nd	>256	48	GEN, KAN, PEN	aac(6′)-Ie-aph(2′′)-Ia, aph(3′)-IIIa, aad6, ermB	no	esp, hyl	fms17, fms5, fms19
3559	159/6-D/nd	>256	48	GEN, KAN, PEN	aac(6′)-Ie-aph(2′′)-Ia, aph(3′)-IIIa, aad6, ermB	no	esp, hyl	fms17, fms5,
3560	1/7-B/18	>256	48	GEN, KAN, RIF, TET	aac(6′)-Ie-aph(2′′)-Ia, aph(3′)-IIIa, ermB, tetM	ERY	hyl	fms5, fms19
3561	11/4-C/202	>256	32	GEN, KAN, RIF, TET	aac(6′)-Ie-aph(2′′)-Ia, aph(2′′)-Ib, aph(3′)-IIIa, ermB, tetM	ERY	esp, hyl	fms17, fms5,
3562^#	1/4-B/18	>256	32	GEN, KAN, RIF, TET	aac(6′)-Ie-aph(2′′)-Ia, aph(3′)-IIIa, ermB, tetM	no	hyl	fms5, fms19
3563	159/6-E/192	>256	48	GEN, KAN, RIF	aac(6′)-Ie-aph(2′′)-Ia, aph(2′′)-Ib, aph(3′)-IIIa, aad6, ermB	no	esp, hyl	fms17, fms5, fms19
3564^y	7/12/18	>256	48	GEN, KAN, RIF, TET	aac(6′)-Ie-aph(2′′)-Ia, aph(2′′)-Ib, aph(3′)-IIIa, ermB, tetM	ERY	esp, hyl	fms17, fms5, fms19
3567^y#	144/13/18	>256	48	GEN, KAN, RIF, TET	aac(6′)-Ie-aph(2′′)-Ia, aph(2′′)-Ib, ermB	ERY	hyl	fms17, fms5, fms19
IH ( = 17)				GEN (15), KAN (17), STR (6), TET (7), RIF (15)	*cat* (1), *aac(6′)-Ie-aph(2′′)-Ia* (15), *aph(2′′)-Ib* (10), *aph(3′)-IIIa* (15), *aad6* (10), *ermB* (17), *tetM* (8)	ERY (11), GEN (1)	*hyl* (17), esp (14)	*fms17* (15), *fms5* (15), *fms19* (15)

IO and IH ( = 44)				CHL (1), GEN (24), KAN (25), STR (12), TET (27), RIF (41)	*cat* (2), *aac(6′)-Ie-aph(2′′)-Ia* (23), *aph(2′′)-Ib* (10), *aph(3′)-IIIa* (15), *aad6* (16), *ermB* (43), *tetM* (34)	ERY (34), TET (1), GEN (1)	*hyl* (38), *esp* (15)	*fms17* (23), *fms5* (42), *fms19* (42)

: not determined; : no transconjugants obtained; two isolates with the prototype Tn1546 marked with an asterisk; ^#isolates from blood; ^aall isolates resistant to vancomycin, teicoplanin, penicillin, ampicillin, ciprofloxacin, erythromycin, and clindamycin; ^bfive isolates with tet(M) showed intermediate susceptibility to tetracycline and one isolate with tet(M) was susceptible to this compound, one tetracycline-resistant isolate (3567) was negative for the determinants tested; for four isolates with the MIC values for streptomycin increased (512 mg/L); one isolate with cat showed an intermediate resistance to chloramphenicol; ^call isolates were positive for the vanA gene; ^dall isolates positive for the pilA gene; ^x,yisolates from the same patients “X” and “Y”; RIF: rifampin; CHL: choramphenicol; GEN: gentamicin (HLGR); STR: streptomycin (HLSR); KAN: kanamycin (HLKR); TET: tetracycline. For the summarized results, the number of isolates is given in brackets.