JAC Advance Access published online on July 1, 2003
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkg315
© 2003 by The British Society for Antimicrobial Chemotherapy
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Original article
1 Division of Clinical
Microbiology, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, S-581 85
Linköping,
Sweden
* Corresponding author. E-mail: aniha{at}imk.liu.se.
Received 3 May 2002
; revised 24 April 2003
; accepted 2 May 2003
We studied 45 isolates of Enterococcus
faecalis with high-level gentamicin resistance (HLGR), all
but one concomitantly resistant to ciprofloxacin, and 25 ciprofloxacin-resistant
isolates without HLGR for genetic relatedness using pulsed-field
gel electrophoresis (PFGE). E. faecalis were isolated
from patients admitted to intensive care units at eight hospitals
in southern Sweden from December 1996 through December 1998. Genomic
analysis by PFGE resulted in three clusters of genetically related
isolates (designated clusters I, II and III) and 23 unique clones.
Cluster I was found predominantly in the eastern and central parts
of southern Sweden and clusters II and III in south-western Sweden.
Among the 45 isolates with HLGR, 69% belonged to cluster
I, 20% to cluster II, and 11% had unique PFGE
patterns, which suggests that the majority of isolates with HLGR
are closely related. Among the 25 ciprofloxacin-resistant isolates
without HLGR, 68% had unique PFGE patterns, 12% belonged
to cluster I and 20% to cluster III, which suggests the
ciprofloxacin-resistant isolates are not related. All isolates with
HLGR contained the aac(6')Ie-aph(2'')Ia gene,
which was carried on a Tn5281-like transposon in
all isolates except one. We conclude that HLGR in E.
faecalis was mainly due to dissemination of genetically related
clones during the time studied, and that HLGR in these isolates
was due to the presence of the aac(6')Ie-aph(2'')Ia gene.
Keywords: enterococcus, high-level gentamicin resistance,
pulsed-field gel electrophoresis, transposon
Genetic relatedness among Enterococcus
faecalis with
transposon-mediated high-level gentamicin resistance in Swedish intensive
care units
2 Department
of Biomedicine and Surgery, Faculty of Health Sciences, S-581 85
Linköping,
Sweden
3 Division of Infectious Diseases, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, S-581 85
Linköping,
Sweden
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