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08 15, 2019;9 (1): 11917.

Molecular analysis and epidemiological typing of Vancomycin-resistant Enterococcus outbreak strains.

Anbjørg Rangberg, Astri Lervik Larsen, Oliver Kacelnik, Hanne Skarpodde Sæther, Marthe Bjørland, Jetmund Ringstad, Christine Monceyron Jonassen
Author Information
  1. Anbjørg Rangberg: Center for Laboratory Medicine, Østfold Hospital Trust, Grålum, Norway. anbjra@so-hf.no.
  2. Astri Lervik Larsen: Center for Laboratory Medicine, Østfold Hospital Trust, Grålum, Norway.
  3. Oliver Kacelnik: Department of Antibiotic Resistance and Infection Prevention, Norwegian Institute of Public Health, Oslo, Norway.
  4. Hanne Skarpodde Sæther: Center for Laboratory Medicine, Østfold Hospital Trust, Grålum, Norway.
  5. Marthe Bjørland: Center for Laboratory Medicine, Østfold Hospital Trust, Grålum, Norway.
  6. Jetmund Ringstad: Department of Infectious Diseases, Østfold Hospital Trust, Grålum, Norway.
  7. Christine Monceyron Jonassen: Center for Laboratory Medicine, Østfold Hospital Trust, Grålum, Norway.
PMID: 31417140 DOI: 10.1038/s41598-019-48436-2

Abstract

Outbreaks of multidrug resistant bacteria including vancomycin-resistant enterococci (VRE) in healthcare institutions are increasing in Norway, despite a low level of resistance compared to other European countries. In this study, we describe epidemiological relatedness of vancomycin-resistant Enterococcus faecium isolated during an outbreak at a Norwegian hospital in 2012-2013. During the outbreak, 9454 fecal samples were screened for VRE by culture and/or PCR. Isolates from 86 patients carrying the vanA resistance gene were characterized using pulsed-field gel electrophoresis (PFGE), MALDI-TOF mass spectrometry and single nucleotide polymorphism typing. PFGE revealed two main clusters, the first comprised 56 isolates related to an initial outbreak strain, and the second comprised 21 isolates originating from a later introduced strain, together causing two partly overlapping outbreaks. Nine isolates, including the index case were not related to the two outbreak clusters. In conclusion, the epidemiological analyses show that the outbreak was discovered by coincidence, and that infection control measures were successful. All typing methods identified the two outbreak clusters, and the experiment congruence between the MALDI-TOF and the PFGE clustering was 63.2%, with a strong correlation (r = 72.4%). Despite lower resolution compared to PFGE, MALDI-TOF may provide an efficient mean for real-time monitoring spread of infection.

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MeSH Term

Disease Outbreaks
Feces
Gram-Positive Bacterial Infections
Humans
Medical Records
Multilocus Sequence Typing
Phylogeny
Polymorphism, Single Nucleotide
Seasons
Vancomycin-Resistant Enterococci
Journal Article
Article has an altmetric score of 1

Word Cloud

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