Molecular characterization of a widespread, pathogenic, and antibiotic resistance-receptive Enterococcus faecalis lineage and dissemination of its putative pathogenicity island
Molecular characterization of a widespread, pathogenic, and antibiotic resistance-receptive Enterococcus faecalis lineage and dissemination of its putative pathogenicity island
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DOI：
10.1128/jb.187.16.5709-5718.2005
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发表时间：
2005-08-01
影响因子：
3.2
通讯作者：
Murray, BE
中科院分区：
文献类型：
--
作者：
Nallapareddy, SR;Huang, WX;Murray, BE
粪肠球菌是心内膜炎的常见病因，以其将抗生素耐药性转移给其他病原体的能力而闻名，最近已成为一种重要的多重耐药医院病原体。然而，关于其谱系和该物种特定克隆传播和引起疾病的潜力的知识是有限的。使用九基因多位点序列分型（MLST）方案，我们确定了一个不断发展和广泛的粪肠球菌克隆复合体，导致爆发和危及生命的感染。此外，发现这种不寻常的克隆复合物含有意想不到的相关性分离株，包括第一个已知的美国万古霉素耐药肠球菌（E。faecalis菌株V583）、第一个已知的产青霉素酶（Bla（+））E.粪肠球菌分离株，以及先前描述的青霉素酶生产者的广泛克隆，在<0.1%的粪肠球菌分离株中发现的性状。发现该克隆群的所有成员（命名为Bla（+）货车（r）心内膜炎的BVE）均含有先前描述的推定致病岛（PAI）。进一步的分析表明，这种PAI在世界范围内传播，虽然有相当大的变化，证实了其与临床分离株，并发现一个共同的插入位点在不同的克隆谱系。PAI缺失、MLST和不常见的抗性被用来预测BVE克隆簇的进化。发现了一个毒力很强的克隆复合体。具有不同成员的粪便菌对首选的主要疗法（氨比西林和万古霉素）具有耐药性，对毒力和成功谱系的演变以及公共卫生监测和控制具有重要意义。
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.