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JAC Advance Access originally published online on November 18, 2002
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Journal of Antimicrobial Chemotherapy (2002) 50, 1035-1038
© 2002 The British Society for Antimicrobial Chemotherapy

High occurrence of esp among ampicillin-resistant and vancomycin-susceptible Enterococcus faecium clones from hospitalized patients

Teresa M. Coque1,*, Rob Willems2, Rafael Cantón1, Rosa Del Campo1 and Fernando Baquero1

1 Servicio de Microbiología, Hospital Ramón y Cajal, Carretera de Colmenar, km. 9.1, Madrid 28034, Spain; 2 Research Laboratory for Infectious Diseases (LIO), National Institute of Public Health and the Environment (RIVM) Bilthoven, The Netherlands

Received 22 May 2002; returned 24 June 2002; revised 4 September 2002; accepted 5 September 2002

The ability to colonize patients successfully may be essential for the emergence and spread of resistant nosocomial strains. We determined the presence of Esp, a surface protein involved in colonization ability in Enterococcus faecalis, in 96 Enterococcus faecium isolates from hospitalized patients (77 PFGE clones), 33 faecal isolates from healthy volunteers (32 clones) and 20 environmental isolates (20 clones). Esp was found significantly more often in E. faecium isolated from hospitalized patients than in isolates from the community setting (26% versus 6%, P < 0.01) and was significantly more common among ampicillin-resistant than among ampicillin-susceptible strains (37% versus 4%, P < 0.001), regardless of the isolation site. The frequency of the esp gene in the hospital clearly correlates with antibiotic-resistant E. faecium clones. This observation indicates that antibiotic-resistant variants may frequently arise under antibiotic selective pressure among esp-positive clones reaching ecological abundance in the nosocomial habitat.

Keywords: esp, Enterococcus faecium, ampicillin

* Corresponding author. Tel: +34-91-336-83-30; Fax: +34-91-336-88-09; E-mail: mcoque{at}hrc.insalud.es


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