Genetická příbuznost kmenů <I>Enterococcus faecium</I> VanA u pacientů s hemato-onkologickým onemocněním
| Title in English | Molecular-biology analysis of Enterococcus faecium VanA strains in hemato-oncological patients |
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| Authors | |
| Year of publication | 2003 |
| Type | Article in Periodical |
| Magazine / Source | Klinická mikrobiologie a infekční lékařství |
| MU Faculty or unit | |
| Citation | |
| Web | http://kmil.trios.cz/obsah0603.htm |
| Field | Genetics and molecular biology |
| Keywords | Enterococcus faeciun; vancomycin resistance; molecular diagnostics |
| Description | Aim of the study: The aim of this work was the molecular-biology analysis of Enterococcus faeciumVanA strains that were isolated from clinical material of the patients hospitalized at the Department of Hemato-Oncology (DHO) of the Teaching Hospital in Olomouc (Czech Republic) from 1997 to 2002, from the environment of this department and formulation of the hypothesis on the source and spread of the VRE. Material and methods: Enterococci were isolated and identified using conventional methods of cultivation including determination of antibiotic susceptibility. Molecular-biology analysis was performed in vancomycin-resistant E. faeciumVanA strains isolated in various patients and from the environment of the DHO. A macrorestrictional analysis of the total chromosomal DNA that was broken by the restriction endonucleasis SmaI was used for the determination of the relationship of strains. This analysis was performed by pulse gel electrophoresis (CHEF, Mapper, Bio-Rad) that was followed by statistical processing of the restriction profiles by pooled analysis (Gel Compar, Applied Maths). Results: 2 647 strains of Enterococcus sp.were isolated during the follow-up period totally and 121 strains of them (4.6 %) were identified as VRE. Most common strains were E. faeciumphenotype VanA (78 %) and E. faecalisphenotype VanB (10 %). Five strains of E. faecium VanA were isolated from the environment of the DHO including nasal swabs, hair and uniforms of health care providers. Twenty five to thirty three fragments sized 18 to 470 kb originate in SmaI macrorestrictional spectrum of genomic DNA of 60 E. faecium VanA strains and 28 unique restrictional profiles were identified, whose similarity varied from 62 to 97 %. Four frequently presented clonal types with 5 and more strains, whose similarity of DNA-profile was 90 %, were identified among these profiles. Three from five E. faecium VanA strains isolated from the environment had a unique profile that was not similar to any of clinical isolates and two strains are identical with the strains isolated from the patients. Conclusion: Based on the obtained results, both endogenous and exogenous origins of isolated E. faecium VanA could be supposed. Possibility of survival of these strains in the hospital department environment and subsequent transmission on hospitalized patients could be confirmed. Simultaneously, endogenous origin of these strains and subsequent selection caused by wide-spectral antibiotic treatment should be admitted. |
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