Genetic description of VanD phenotype vanA genotype in vancomycin-resistant Enterococcus faecium isolates from a Bone Marrow Transplantation Unit

Background Vancomycin-resistant Enterococcus faecium (VREfm) is an important agent of hospital-acquired infection. VanA phenotype is characterized by resistance to high levels of vancomycin and teicoplanin and is encoded by the van A gene, whereas VanD phenotype is characterized by resistance to van...

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Bibliographic Details
Published in:Brazilian journal of microbiology 2022-03, Vol.53 (1), p.245-250
Main Authors: Marchi, Ana Paula, Neto, Lauro Vieira Perdigão, Côrtes, Marina Farrel, de Castro Lima, Victor Augusto Camarinha, Martins, Roberta Cristina Ruedas, Franco, Lucas Augusto Moyses, Rossi, Flavia, Rocha, Vanderson, Levin, Anna S., Costa, Silvia Figueiredo
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - pharmacology
Anti-Bacterial Agents - therapeutic use
Antibiotic resistance
Antibiotics
Bacterial Proteins - genetics
Biomedical and Life Sciences
Bone marrow
Bone Marrow Transplantation
Carbon-Oxygen Ligases - genetics
Clinical Microbiology - Short Communication
Enterococcus faecium
Enterococcus faecium - genetics
Food Microbiology
Gene sequencing
Genes
Genetic structure
Genetic variability
Genomes
Genotype
Genotype & phenotype
Genotypes
Gram-Positive Bacterial Infections - microbiology
Humans
Insertion
Life Sciences
Medical Microbiology
Microbial Ecology
Microbial Genetics and Genomics
Microbiology
Minimum inhibitory concentration
Mycology
Phenotype
Phenotypes
Stem cell transplantation
Teicoplanin
Transplantation
Transposon Tn1546
VanA gene
Vancomycin
Vancomycin - pharmacology
Vancomycin Resistance
Vans
VanZ gene
Whole genome sequencing
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Summary:Background Vancomycin-resistant Enterococcus faecium (VREfm) is an important agent of hospital-acquired infection. VanA phenotype is characterized by resistance to high levels of vancomycin and teicoplanin and is encoded by the van A gene, whereas VanD phenotype is characterized by resistance to vancomycin and susceptibility or intermediate resistance to teicoplanin; however, some isolates carry a VanD phenotype with a vanA genotype, but there are many gaps in the knowledge about the genetic mechanisms behind this pattern. Objective To characterize the genetic structure, clonality, and mobile genetic elements of VRE isolates that display a VanD- van A phenotype. Results All vanA VRE-fm isolates displayed minimum inhibitory concentration (MIC) for vancomycin > 32µg/mL and intermediate or susceptible MIC range for teicoplanin (8–16µg/mL). The isolates were not clonal, and whole-genome sequencing analysis showed that they belonged to five different STs (ST478, ST412, ST792, ST896, and ST1393). The absence of some van complex genes were observed in three isolates: Ef5 lacked vanY and vanZ , Ef2 lacked vanY , and Ef9 lacked orf 1 and orf 2; moreover, another three isolates had inverted positions of orf1 , orf2 , vanR , and vanS genes. IS 1542 was observed in all isolates, whereas IS 1216 in only five. Moreover, presence of other hypothetical protein-encoding genes located downstream the vanZ gene were observed in six isolates. Conclusion VRE isolates can display some phenotypes associated to vanA genotype, including VanA and VanB, as well as VanD; however, further studies are needed to understand the exact role of genetic variability, rearrangement of the transposon Tn1546, and presence of insertion elements in isolates with this profile.
ISSN:1517-8382
1678-4405
DOI:10.1007/s42770-021-00634-9