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Molecular Typing and Antimicrobial Susceptibility of Vancomycin-Resistant Enterococcus faecium in Brazil

Published online by Cambridge University Press:  02 January 2015

Rosangela F. Cereda ,
Ana C. Gales ,
Suzane Silbert ,
Ronald N. Jones  and
Helio S. Sader
Rosangela F. Cereda
Affiliation:
Division of Infectious Diseases, Universidade Federal Sao Paulo, Brazil
Ana C. Gales
Affiliation:
Division of Infectious Diseases, Universidade Federal Sao Paulo, Brazil
Suzane Silbert
Affiliation:
Division of Infectious Diseases, Universidade Federal Sao Paulo, Brazil
Ronald N. Jones
Affiliation:
Department of Pathology, University of Iowa College of Medicine, Iowa City, Iowa
Helio S. Sader*
Affiliation:
Division of Infectious Diseases, Universidade Federal Sao Paulo, Brazil
*
Laboratório Especial de Microbiologia Clínica, Infectious Disease Division, Federal University of Sao Paulo, Rua Botucatu, 740. Sao Paulo, SP- CEP 04023-063 – Brazil
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Abstract

Objectives:

To characterize vancomycin-resistant enterococci (VRE) isolates and to evaluate the mode of dissemination of this pathogen in Brazil.

Design:

We collected 22 vancomycin-resistant Enterococcus faecium isolates from 6 medical centers in Sao Paulo, Brazil, and 1 isolate from a medical center in Curitiba, Brazil.

Participants:

All Brazilian hospitals that had identified vancomycin-resistant E. faecium up to the beginning of this study (late 1999) contributed isolates to the study.

Methods:

The isolates were susceptibility tested using the broth microdilution method and the E-test. The presence of vancomycin resistance genes (vanA, vanB, vanC1, vanC2-3, and vanD) was evaluated by polymerase chain reaction; molecular typing was performed by pulsed-field gel electrophoresis (PFGE).

Results:

The vanA gene was demonstrated in all vancomycin-resistant E. faecium, except for 1 isolate. None of the vancomycin resistance genes cited above was detected in the isolate from Curitiba, which was the first vancomycin-resistant E. faecium described in Brazil. All isolates were resistant to ampicillin and teicoplanin. The main clone remains susceptible to doxycycline and chloramphenicol, but intermediate to quinupristin-dalfopristin. PFGE analysis demonstrated 7 major PFGE patterns. A unique PFGE pattern with 4 subtypes was detected in 17 isolates from 4 different hospitals.

Conclusion:

The results of our study indicate the occurrence of intra- and interhospital dissemination of VRE in Sao Paulo, Brazil.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 23 , Issue 1 , January 2002 , pp. 19 - 22
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2002

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