Molecular characterization of a widespread, pathogenic, and antibiotic resistance-receptive Enterococcus faecalis lineage and dissemination of its putative pathogenicity island.

TitleMolecular characterization of a widespread, pathogenic, and antibiotic resistance-receptive Enterococcus faecalis lineage and dissemination of its putative pathogenicity island.
Publication TypeJournal Article
Year of Publication2005
AuthorsNallapareddy, SR, Wenxiang, H, Weinstock, GM, Murray, BE
JournalJ Bacteriol
Volume187
Issue16
Pagination5709-18
Date Published2005 Aug
ISSN0021-9193
KeywordsBacterial Proteins, Chromosomes, Bacterial, Drug Resistance, Bacterial, Endocarditis, Enterococcus faecalis, Genomic Islands, Gram-Positive Bacterial Infections, Humans, Virulence, Virulence Factors
Abstract

Enterococcus faecalis, a common cause of endocarditis and known for its capacity to transfer antibiotic resistance to other pathogens, has recently emerged as an important, multidrug-resistant nosocomial pathogen. However, knowledge of its lineages and the potential of particular clones of this species to disseminate and cause disease is limited. Using a nine-gene multilocus sequence typing (MLST) scheme, we identified an evolving and widespread clonal complex of E. faecalis that has caused outbreaks and life-threatening infections. Moreover, this unusual clonal complex was found to contain isolates of unexpected relatedness, including the first known U.S. vancomycin-resistant enterococcus (E. faecalis strain V583), the first known penicillinase-producing (Bla(+)) E. faecalis isolate, and the previously described widespread clone of penicillinase producers, a trait found in <0.1% of E. faecalis isolates. All members of this clonal cluster (designated as BVE for Bla(+) Van(r) endocarditis) were found to contain a previously described putative pathogenicity island (PAI). Further analysis of this PAI demonstrated its dissemination worldwide, albeit with considerable variability, confirmed its association with clinical isolates, and found a common insertion site in different clonal lineages. PAI deletions, MLST, and the uncommon resistances were used to predict the evolution of the BVE clonal cluster. The finding of a virulent and highly successful clonal complex of E. faecalis with different members resistant to the primary therapies of choice, ampicillin and vancomycin, has important implications for the evolution of virulence and successful lineages and for public health monitoring and control.

DOI10.1128/JB.187.16.5709-5718.2005
Alternate JournalJ. Bacteriol.
PubMed ID16077117
PubMed Central IDPMC1196071
Grant ListR37 AI047923 / AI / NIAID NIH HHS / United States
R37 AI47923 / AI / NIAID NIH HHS / United States