Vancomycin-resistant Enterococcus faecium circulating in a Portuguese hospital (2009-2021) challenges classical infection control
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.48797/sl.2023.78 |
Resumo: | Background: Vancomycin-resistant Enterococcus faecium (VREfm) prevalence greatly varies in European countries yet continues to rise [1]. We aimed to characterize clinical-VREfm from a local hospital (800-beds) during 2009-2021. Methods: VREfm [n=175; mostly from urine (40%)] were collected from medical-47% and surgical-32% wards. Antibiotic-resistance (ABR) and occurrence of vanA/vanB, plasmids [rep-pLG1/rep-pRUM/rep-Inc18(rep1/rep2)] and virulence genes were screened by disk-diffusion/broth-microdilution (EUCAST/CLSI) and PCR, respectively. Representative VREfm/year (n=81) were selected for MLST+WGS (Illumina-NovaSeq) and analysed through CGE-tools (homemade virulence and bacteriocins(bac) databases) and cgMLST/Ridom-SeqSphere+. Results: All isolates were resistant to glycopeptides [98%-vanA;2%-vanB], ampicillin, ciprofloxacin, erythromycin [erm(B)/msr(C)], less to gentamicin (49%;aac(6’)-Ie-aph(2’’)-Ia), tetracycline [27%; tet(M)/tet(L)], quinupristin-dalfopristin (5%) and/or linezolid (2%;GT2576 mutation). VREfm were oligoclonal (until 7 STs/year), mostly clustering into ST117-31%, ST78-19% and ST80-12%. For each ST, different complex-types (CT) were detected each year, but some were identified in different wards from 3-months (ST412-CT258/ST117-CT4659) to 2-4-years (ST117-CT24/CT6602/CT6603; ST78-CT330). Sequenced VREfm showed slight overlap (ST117-CT24 and ST78-CT230) with other global Efm. Recent years (>2019) concentrated the majority of novel CTs, without common clones over time, and ST494 (associated with a German outbreak) was introduced. ABR and virulence patterns were similar throughout the years. Bac-profiles (13 patterns) were similar between common STs/CTs. One new bacteriocin was detected >2017, Bac43 increased over time and BacAS9 was exclusively detected in ST117. The typical VREfm plasmidome [RepA_N-pRUM/pLG1-like, Inc18, Rep3-pB82/pEF418, Rep_Trans-pEFNP1/pRI1] was observed across the years however, Rep-pRUM decreased. A novel RepA_N-replicase (69% nucleotide identity with pRUM) was identified in most VREfm during 2009-2021. In silico analysis showed its occurrence in ~100 Efm-genomes/GenBank from different countries after 2000. Conclusion: Current clinical VREfm display a strong oligoclonal nature. Nosocomial transmission events and/or import of VREfm from colonized patients may explain the long-term persistence of particular clones. The continuous flux between community and hospital clones may feed the emergence of new lineages/opportunities for adaption hampering classical infection control interventions. |
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Vancomycin-resistant Enterococcus faecium circulating in a Portuguese hospital (2009-2021) challenges classical infection controlPosterBackground: Vancomycin-resistant Enterococcus faecium (VREfm) prevalence greatly varies in European countries yet continues to rise [1]. We aimed to characterize clinical-VREfm from a local hospital (800-beds) during 2009-2021. Methods: VREfm [n=175; mostly from urine (40%)] were collected from medical-47% and surgical-32% wards. Antibiotic-resistance (ABR) and occurrence of vanA/vanB, plasmids [rep-pLG1/rep-pRUM/rep-Inc18(rep1/rep2)] and virulence genes were screened by disk-diffusion/broth-microdilution (EUCAST/CLSI) and PCR, respectively. Representative VREfm/year (n=81) were selected for MLST+WGS (Illumina-NovaSeq) and analysed through CGE-tools (homemade virulence and bacteriocins(bac) databases) and cgMLST/Ridom-SeqSphere+. Results: All isolates were resistant to glycopeptides [98%-vanA;2%-vanB], ampicillin, ciprofloxacin, erythromycin [erm(B)/msr(C)], less to gentamicin (49%;aac(6’)-Ie-aph(2’’)-Ia), tetracycline [27%; tet(M)/tet(L)], quinupristin-dalfopristin (5%) and/or linezolid (2%;GT2576 mutation). VREfm were oligoclonal (until 7 STs/year), mostly clustering into ST117-31%, ST78-19% and ST80-12%. For each ST, different complex-types (CT) were detected each year, but some were identified in different wards from 3-months (ST412-CT258/ST117-CT4659) to 2-4-years (ST117-CT24/CT6602/CT6603; ST78-CT330). Sequenced VREfm showed slight overlap (ST117-CT24 and ST78-CT230) with other global Efm. Recent years (>2019) concentrated the majority of novel CTs, without common clones over time, and ST494 (associated with a German outbreak) was introduced. ABR and virulence patterns were similar throughout the years. Bac-profiles (13 patterns) were similar between common STs/CTs. One new bacteriocin was detected >2017, Bac43 increased over time and BacAS9 was exclusively detected in ST117. The typical VREfm plasmidome [RepA_N-pRUM/pLG1-like, Inc18, Rep3-pB82/pEF418, Rep_Trans-pEFNP1/pRI1] was observed across the years however, Rep-pRUM decreased. A novel RepA_N-replicase (69% nucleotide identity with pRUM) was identified in most VREfm during 2009-2021. In silico analysis showed its occurrence in ~100 Efm-genomes/GenBank from different countries after 2000. Conclusion: Current clinical VREfm display a strong oligoclonal nature. Nosocomial transmission events and/or import of VREfm from colonized patients may explain the long-term persistence of particular clones. The continuous flux between community and hospital clones may feed the emergence of new lineages/opportunities for adaption hampering classical infection control interventions.IUCS-CESPU Publishing2023-04-21info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.48797/sl.2023.78https://doi.org/10.48797/sl.2023.78Scientific Letters; Vol. 1 No. Sup 1 (2023)2795-5117reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://publicacoes.cespu.pt/index.php/sl/article/view/78https://publicacoes.cespu.pt/index.php/sl/article/view/78/21Copyright (c) 2023 A. C. Almeida-Santos , B. Duarte , A. P. Tedim , M. D. Fernández-de-Bobadilla , L. M. Silva , H. Ramos , T. M. Coque , C. Novais , A. R. Freitas , L. Peixeinfo:eu-repo/semantics/openAccessAlmeida-Santos , A. C.Duarte , B.Tedim , A. P.Fernández-de-Bobadilla , M. D.Silva , L. M.Ramos , H.Coque , T. M.Novais , C.Freitas , A. R.Peixe , L.2023-04-29T08:46:09Zoai:publicacoes.cespu.pt:article/78Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:50:23.542216Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Vancomycin-resistant Enterococcus faecium circulating in a Portuguese hospital (2009-2021) challenges classical infection control |
title |
Vancomycin-resistant Enterococcus faecium circulating in a Portuguese hospital (2009-2021) challenges classical infection control |
spellingShingle |
Vancomycin-resistant Enterococcus faecium circulating in a Portuguese hospital (2009-2021) challenges classical infection control Almeida-Santos , A. C. Poster |
title_short |
Vancomycin-resistant Enterococcus faecium circulating in a Portuguese hospital (2009-2021) challenges classical infection control |
title_full |
Vancomycin-resistant Enterococcus faecium circulating in a Portuguese hospital (2009-2021) challenges classical infection control |
title_fullStr |
Vancomycin-resistant Enterococcus faecium circulating in a Portuguese hospital (2009-2021) challenges classical infection control |
title_full_unstemmed |
Vancomycin-resistant Enterococcus faecium circulating in a Portuguese hospital (2009-2021) challenges classical infection control |
title_sort |
Vancomycin-resistant Enterococcus faecium circulating in a Portuguese hospital (2009-2021) challenges classical infection control |
author |
Almeida-Santos , A. C. |
author_facet |
Almeida-Santos , A. C. Duarte , B. Tedim , A. P. Fernández-de-Bobadilla , M. D. Silva , L. M. Ramos , H. Coque , T. M. Novais , C. Freitas , A. R. Peixe , L. |
author_role |
author |
author2 |
Duarte , B. Tedim , A. P. Fernández-de-Bobadilla , M. D. Silva , L. M. Ramos , H. Coque , T. M. Novais , C. Freitas , A. R. Peixe , L. |
author2_role |
author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Almeida-Santos , A. C. Duarte , B. Tedim , A. P. Fernández-de-Bobadilla , M. D. Silva , L. M. Ramos , H. Coque , T. M. Novais , C. Freitas , A. R. Peixe , L. |
dc.subject.por.fl_str_mv |
Poster |
topic |
Poster |
description |
Background: Vancomycin-resistant Enterococcus faecium (VREfm) prevalence greatly varies in European countries yet continues to rise [1]. We aimed to characterize clinical-VREfm from a local hospital (800-beds) during 2009-2021. Methods: VREfm [n=175; mostly from urine (40%)] were collected from medical-47% and surgical-32% wards. Antibiotic-resistance (ABR) and occurrence of vanA/vanB, plasmids [rep-pLG1/rep-pRUM/rep-Inc18(rep1/rep2)] and virulence genes were screened by disk-diffusion/broth-microdilution (EUCAST/CLSI) and PCR, respectively. Representative VREfm/year (n=81) were selected for MLST+WGS (Illumina-NovaSeq) and analysed through CGE-tools (homemade virulence and bacteriocins(bac) databases) and cgMLST/Ridom-SeqSphere+. Results: All isolates were resistant to glycopeptides [98%-vanA;2%-vanB], ampicillin, ciprofloxacin, erythromycin [erm(B)/msr(C)], less to gentamicin (49%;aac(6’)-Ie-aph(2’’)-Ia), tetracycline [27%; tet(M)/tet(L)], quinupristin-dalfopristin (5%) and/or linezolid (2%;GT2576 mutation). VREfm were oligoclonal (until 7 STs/year), mostly clustering into ST117-31%, ST78-19% and ST80-12%. For each ST, different complex-types (CT) were detected each year, but some were identified in different wards from 3-months (ST412-CT258/ST117-CT4659) to 2-4-years (ST117-CT24/CT6602/CT6603; ST78-CT330). Sequenced VREfm showed slight overlap (ST117-CT24 and ST78-CT230) with other global Efm. Recent years (>2019) concentrated the majority of novel CTs, without common clones over time, and ST494 (associated with a German outbreak) was introduced. ABR and virulence patterns were similar throughout the years. Bac-profiles (13 patterns) were similar between common STs/CTs. One new bacteriocin was detected >2017, Bac43 increased over time and BacAS9 was exclusively detected in ST117. The typical VREfm plasmidome [RepA_N-pRUM/pLG1-like, Inc18, Rep3-pB82/pEF418, Rep_Trans-pEFNP1/pRI1] was observed across the years however, Rep-pRUM decreased. A novel RepA_N-replicase (69% nucleotide identity with pRUM) was identified in most VREfm during 2009-2021. In silico analysis showed its occurrence in ~100 Efm-genomes/GenBank from different countries after 2000. Conclusion: Current clinical VREfm display a strong oligoclonal nature. Nosocomial transmission events and/or import of VREfm from colonized patients may explain the long-term persistence of particular clones. The continuous flux between community and hospital clones may feed the emergence of new lineages/opportunities for adaption hampering classical infection control interventions. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-04-21 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.48797/sl.2023.78 https://doi.org/10.48797/sl.2023.78 |
url |
https://doi.org/10.48797/sl.2023.78 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://publicacoes.cespu.pt/index.php/sl/article/view/78 https://publicacoes.cespu.pt/index.php/sl/article/view/78/21 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
IUCS-CESPU Publishing |
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IUCS-CESPU Publishing |
dc.source.none.fl_str_mv |
Scientific Letters; Vol. 1 No. Sup 1 (2023) 2795-5117 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799131583755583488 |