Polyclonal emergence of vanA vancomycin-resistant Enterococcus faecium in Australia

Sebastiaan J van Hal; Björn A Espedido; Geoffrey W Coombs; Benjamin P Howden; Tony M Korman; Graeme R Nimmo; Iain B Gosbell; Slade O Jensen

doi:10.1093/jac/dkw539

Polyclonal emergence of vanA vancomycin-resistant Enterococcus faecium in Australia

J Antimicrob Chemother. 2017 Apr 1;72(4):998-1001. doi: 10.1093/jac/dkw539.

Authors

Sebastiaan J van Hal^{1

2}, Björn A Espedido^{1

3}, Geoffrey W Coombs^{4

5}, Benjamin P Howden^{6

7}, Tony M Korman⁸, Graeme R Nimmo⁹, Iain B Gosbell^{1

3

10}, Slade O Jensen^{1

3}

Affiliations

¹ School of Medicine, Western Sydney University, Sydney, NSW, Australia.
² Royal Prince Alfred Hospital, Sydney, NSW, Australia.
³ Antimicrobial Resistance and Mobile Elements Group, Ingham Institute for Applied Medical Research, Sydney, NSW, Australia.
⁴ School of Veterinary and Life Sciences, Murdoch University, Perth, WA, Australia.
⁵ PathWest Laboratory Medicine, Fiona Stanley Hospital, Perth, WA, Australia.
⁶ Austin Health, Melbourne, Vic., Australia.
⁷ Department of Microbiology and Immunology, The University of Melbourne, Melbourne, Vic., Australia.
⁸ Monash Hospital, Melbourne, Vic., Australia.
⁹ Pathology Queensland, Brisbane, QLD, Australia.
¹⁰ Sydney South Western Pathology Service, NSW Pathology, Sydney, NSW, Australia.

PMID: 28031272
DOI: 10.1093/jac/dkw539

Abstract

Objectives: To investigate the genetic context associated with the emergence of vanA VRE in Australia.

Methods: The whole genomes of 18 randomly selected vanA -positive Enterococcus faecium patient isolates, collected between 2011 and 2013 from hospitals in four Australian capitals, were sequenced and analysed.

Results: In silico typing and transposon/plasmid assembly revealed that the sequenced isolates represented (in most cases) different hospital-adapted STs and were associated with a variety of different Tn 1546 variants and plasmid backbone structures.

Conclusions: The recent emergence of vanA VRE in Australia was polyclonal and not associated with the dissemination of a single 'dominant' ST or vanA -encoding plasmid. Interestingly, the factors contributing to this epidemiological change are not known and future studies may need to consider investigation of potential community sources.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Australia / epidemiology
Bacterial Proteins / genetics*
Carbon-Oxygen Ligases / genetics*
DNA Transposable Elements
Enterococcus faecium / classification*
Enterococcus faecium / drug effects
Enterococcus faecium / genetics
Enterococcus faecium / isolation & purification*
Genetic Variation*
Genome, Bacterial
Gram-Positive Bacterial Infections / epidemiology
Gram-Positive Bacterial Infections / microbiology*
Hospitals
Humans
Molecular Typing
Plasmids / analysis
Sequence Analysis, DNA
Vancomycin-Resistant Enterococci / classification*
Vancomycin-Resistant Enterococci / genetics*

Substances

Bacterial Proteins
DNA Transposable Elements
VanA ligase, Bacteria
Carbon-Oxygen Ligases