TY - JOUR
T1 - Emergence of vanA Enterococcus faecium in Denmark, 2005-15
AU - Hammerum, Anette M.
AU - Baig, Sharmin
AU - Kamel, Yasmin
AU - Roer, Louise
AU - Pinholt, Mette
AU - Gumpert, Heidi
AU - Holzknecht, Barbara
AU - Røder, Bent
AU - Justesen, Ulrik S.
AU - Samulioniené, Jurgita
AU - Kjærsgaard, Mona
AU - Østergaard, Claus
AU - Holm, Anette
AU - Dzajic, Esad
AU - Søndergaard, Turid Snekloth
AU - Gaini, Shahin
AU - Edquist, Petra
AU - Alm, Erik
AU - Lilje, Berit
AU - Westh, Henrik
AU - Stegger, Marc
AU - Hasman, Henrik
PY - 2017/8/1
Y1 - 2017/8/1
N2 - Objectives: To describe the changing epidemiology of vancomycin-resistant Enterococcus faecium and Enterococcus faecalis in clinical samples in Denmark 2005-15 according to species and van type, and, furthermore, to investigate the genetic relatedness of the clinical E. faeciumisolates from 2015. Methods: During 2005-14, all clinical VRE isolates were tested for the presence of vanA/B/C genes by PCR. In 2015, all clinical VRE isolates were whole-genome sequenced. From the WGS data, the presence of van genes and MLST STs were extracted in silico. Core-genome MLST (cgMLST) analysis was performed for the vancomycinresistant E. faecium isolates. Results: During 2005-15, 1043 vanA E. faecium, 25 vanB E. faecium, 4 vanA E. faecalis and 28 vanB E. faecalis were detected. The number of VRE was <50 isolates/year until 2012 to >200 isolates/year in 2013-15. In 2015, 368 vanA E. faecium and 1 vanB E. faecium were detected along with 1 vanA E. faecalis and 1 vanB E. faecalis. cgMLST subdivided the 368 vanA E. faecium isolates into 33 cluster types (CTs), whereas the vanB E. faecium isolate belonged to a different CT. ST203-CT859 was most prevalent (51%), followed by ST80-CT14 (22%), ST117- CT24 (6%), ST80-CT866 (4%) and ST80-CT860 (2%). Comparison with the cgMLST.org database, previous studies and personal communications with neighbouring countries revealed that the novel cluster ST203-CT859 emerged in December 2014 and spread to the south of Sweden and the Faroe Islands during 2015. Conclusions: VRE increased in Denmark during 2005-15 due to the emergence of several vanA E. faeciumclones.
AB - Objectives: To describe the changing epidemiology of vancomycin-resistant Enterococcus faecium and Enterococcus faecalis in clinical samples in Denmark 2005-15 according to species and van type, and, furthermore, to investigate the genetic relatedness of the clinical E. faeciumisolates from 2015. Methods: During 2005-14, all clinical VRE isolates were tested for the presence of vanA/B/C genes by PCR. In 2015, all clinical VRE isolates were whole-genome sequenced. From the WGS data, the presence of van genes and MLST STs were extracted in silico. Core-genome MLST (cgMLST) analysis was performed for the vancomycinresistant E. faecium isolates. Results: During 2005-15, 1043 vanA E. faecium, 25 vanB E. faecium, 4 vanA E. faecalis and 28 vanB E. faecalis were detected. The number of VRE was <50 isolates/year until 2012 to >200 isolates/year in 2013-15. In 2015, 368 vanA E. faecium and 1 vanB E. faecium were detected along with 1 vanA E. faecalis and 1 vanB E. faecalis. cgMLST subdivided the 368 vanA E. faecium isolates into 33 cluster types (CTs), whereas the vanB E. faecium isolate belonged to a different CT. ST203-CT859 was most prevalent (51%), followed by ST80-CT14 (22%), ST117- CT24 (6%), ST80-CT866 (4%) and ST80-CT860 (2%). Comparison with the cgMLST.org database, previous studies and personal communications with neighbouring countries revealed that the novel cluster ST203-CT859 emerged in December 2014 and spread to the south of Sweden and the Faroe Islands during 2015. Conclusions: VRE increased in Denmark during 2005-15 due to the emergence of several vanA E. faeciumclones.
UR - http://www.scopus.com/inward/record.url?scp=85027113987&partnerID=8YFLogxK
U2 - 10.1093/jac/dkx138
DO - 10.1093/jac/dkx138
M3 - Article
C2 - 28541565
AN - SCOPUS:85027113987
SN - 0305-7453
VL - 72
SP - 2184
EP - 2190
JO - Journal of Antimicrobial Chemotherapy
JF - Journal of Antimicrobial Chemotherapy
IS - 8
M1 - dkx138
ER -