Emergence of high-risk multidrug-resistant Enterococcus faecalis CC2 (ST181) and CC87 (ST28) causing healthcare-associated infections in India.

This study aimed to establish the epidemiology and clonal composition of 134 clinical E. faecalis isolates and to link molecular typing data with antimicrobial resistance and virulence determinants. All isolates were identified by conventional methods and confirmed by PCR (16srRNA and ddl gene of E. faecalis) in 5 years. Disk diffusion test performed on all strains. We screened all E. faecalis for aac(6')-aph(2″), vanA, and vanB resistance genes, and aggregation substance-asa1, cytolysin-cylA, collagen-binding protein-ace, enterococcal surface protein-esp, gelatinase-gelE, and hyaluronidase-hyl virulence genes by PCR. Representative isolates of E. faecalis characterized by PFGE and MLST. Of 134 isolates, 79.1% and 61.9% isolates were HLGR and MDR. Rates of resistance to multiple antibiotics were significantly greater among MDR E. faecalis. In multivariate analysis, independent predictor for infection due to MDR E. faecalis strains was a surgical intervention (OR 2.41, 95% CI 1.17-4.96, P = 0·017). Overall, the observed rate of in-hospital mortality was 11.9%. The gelE, asa1, ace, cylA, esp and hyl genes detected with percentages of 87.3%, 78.4%, 54.5%, 53.7, 36.6% and 3.0% in E. faecalis isolates respectively. The asaI, cylA, and gelE genes were significantly correlated with MDR E. faecalis. PFGE analysis showed 28 clones with four major clones. MLST analysis revealed two sequence types-ST28 (CC87) and ST181 (CC2). The first report on the emergence of the high-risk h...
Source: Infection, Genetics and Evolution - Category: Genetics & Stem Cells Authors: Tags: Infect Genet Evol Source Type: research