Clinical and microbiological characteristics of vancomycin-resistant enterococci with the vand phenotype and vana genotype

Joon-Young Song, Hee-Jin Cheong, Yu Bin Seo, In Seon Kim, Jung Yeon Heo, Ji Yun Noh, Wonseok Choi, Woo Joo Kim

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6 Citations (Scopus)

Abstract

Vancomycin-resistant enterococci (VRE) strains with the VanD phenotype and vanA genotype (VanD-vanA) have been reported in Asian countries. The VanD phenotype is characterized by low-level resistance to vancomycin and susceptibility or intermediate resistance to teicoplanin. We retrospectively determined the risk factors, clinical outcomes, and virulence factors for VanD-vanA VRE (20 patients colonized with Enterococcus faecium) compared to VanA-vanA VRE (20 patients colonized with E. faecium). Multiple VRE colonizations and recent glycopeptide use were related to the presence of the VanA phenotype. There were no significant differences between patients colonized with VanD-vanA VRE and VanA-vanA VRE for duration of hospital stay, duration of intensive care unit stay, or hospital mortality. The esp gene was identified from all enterococci, while 90z of VanD-vanA VRE isolates and 95z of VanA-vanA VRE isolates were positive for the hyl gene. VanA-vanA VRE was subsequently isolated from sequential samples in 8 of 20 patients (40z) with VanD-vanA VRE. All of these patients had received glycopeptides during the interval between sample collection, and 2 of 8 paired isolates (VanD-vanA VRE and VanA-vanA VRE) were closely related subtypes according to pulsed-field gel electrophoresis analysis. In conclusion, VanD-vanA VRE isolates might represent an unstable, heterogeneous population that can convert to the VanA phenotype after exposure to glycopeptides.

Original languageEnglish
Pages (from-to)1-5
Number of pages5
JournalJapanese Journal of Infectious Diseases
Volume66
Issue number1
DOIs
Publication statusPublished - 2013 Jan 1

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Genotype
Phenotype
Glycopeptides
Enterococcus faecium
Vancomycin-Resistant Enterococci
Vancomycin Resistance
Teicoplanin
Pulsed Field Gel Electrophoresis
Enterococcus
Virulence Factors
Hospital Mortality
Genes
Intensive Care Units
Length of Stay

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

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title = "Clinical and microbiological characteristics of vancomycin-resistant enterococci with the vand phenotype and vana genotype",
abstract = "Vancomycin-resistant enterococci (VRE) strains with the VanD phenotype and vanA genotype (VanD-vanA) have been reported in Asian countries. The VanD phenotype is characterized by low-level resistance to vancomycin and susceptibility or intermediate resistance to teicoplanin. We retrospectively determined the risk factors, clinical outcomes, and virulence factors for VanD-vanA VRE (20 patients colonized with Enterococcus faecium) compared to VanA-vanA VRE (20 patients colonized with E. faecium). Multiple VRE colonizations and recent glycopeptide use were related to the presence of the VanA phenotype. There were no significant differences between patients colonized with VanD-vanA VRE and VanA-vanA VRE for duration of hospital stay, duration of intensive care unit stay, or hospital mortality. The esp gene was identified from all enterococci, while 90z of VanD-vanA VRE isolates and 95z of VanA-vanA VRE isolates were positive for the hyl gene. VanA-vanA VRE was subsequently isolated from sequential samples in 8 of 20 patients (40z) with VanD-vanA VRE. All of these patients had received glycopeptides during the interval between sample collection, and 2 of 8 paired isolates (VanD-vanA VRE and VanA-vanA VRE) were closely related subtypes according to pulsed-field gel electrophoresis analysis. In conclusion, VanD-vanA VRE isolates might represent an unstable, heterogeneous population that can convert to the VanA phenotype after exposure to glycopeptides.",
author = "Joon-Young Song and Hee-Jin Cheong and Seo, {Yu Bin} and Kim, {In Seon} and Heo, {Jung Yeon} and Noh, {Ji Yun} and Wonseok Choi and Kim, {Woo Joo}",
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AU - Song, Joon-Young

AU - Cheong, Hee-Jin

AU - Seo, Yu Bin

AU - Kim, In Seon

AU - Heo, Jung Yeon

AU - Noh, Ji Yun

AU - Choi, Wonseok

AU - Kim, Woo Joo

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