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Appearance of vanD-positive Enterococcus faecium in a tertiary hospital in the Netherlands: prevalence of vanC and vanD in hospitalized patients
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Appearance of vanD-positive Enterococcus faecium in a tertiary hospital in the Netherlands: prevalence of vanC and vanD in hospitalized patients
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Journal Article
Appearance of vanD-positive Enterococcus faecium in a tertiary hospital in the Netherlands: prevalence of vanC and vanD in hospitalized patients
2019
Overview
Vancomycin-resistant enterococci (VRE) can rapidly spread through hospitals. Therefore, our hospital employs a screening program whereby rectal swabs are screened for the presence of
vanA
and
vanB
, and only PCR-positive broths are cultured on VRE selection agar. Early November 2016, a clinical
vanA-
/
vanB
-negative VRE isolate was detected in a
vanA/vanB
-screening-negative patient, giving the possibility that an undetected VRE might be spreading within our hospital. Whole-genome-sequencing of the isolate showed that resistance was
vanD
-mediated and core genome multilocus sequence typing showed it was a rare type: ST17/CT154. To determine the prevalence of
vanA/B/C/D
-carrying enterococci, we designed a real-time PCR for
vanC1/2/3
and
vanD
and screened rectal swabs from 360 patients.
vanD
was found in 27.8% of the patients, yet culture demonstrated only
E
.
faecium
from
vanA
-positive broths and
E
.
gallinarum
from
vanC1
-positive broths. No
vanD
-positive VRE were found, limiting the possibility of nosocomial spread of this VRE. Moreover, the high prevalence of non-VRE
vanD
in rectal swabs makes it unfeasible to include the
vanD
PCR in our VRE screening. However, having validated the
vanC1/2/3
and
vanD
PCRs allows us to rapidly check future
vanA/B
-negative VRE for the presence of
vanC
and
vanD
genes.
Publisher
Nature Publishing Group UK,Nature Publishing Group,Nature Portfolio
Subject
/ 45/77
/ Bacterial Proteins - genetics
/ Enterococcus faecium - classification
/ Enterococcus faecium - drug effects
/ Enterococcus faecium - genetics
/ Genomes
/ Gram-Positive Bacterial Infections - diagnosis
/ Gram-Positive Bacterial Infections - drug therapy
/ Gram-Positive Bacterial Infections - epidemiology
/ Gram-Positive Bacterial Infections - microbiology
/ Humanities and Social Sciences
/ Humans
/ Male
/ Patients
/ Peptide Synthases - genetics
/ Rectum
/ Science
