Table 2.
Clonal relatedness, antimicrobial resistance profiles, and distribution of resistance and virulence determinants among IO and IH outbreak isolates.
| Isolate | MT/PT/ST | MIC VAN (mg/L) | MIC TEI (mg/L) | Resistance phenotypesa,b | Resistance determinantsb,c | Cotransferred resistance | Virulence genes | Pili genesd |
|---|---|---|---|---|---|---|---|---|
| Institute of oncology | ||||||||
| 988 | 1/2-A/17 | >256 | 32 | RIF | ermB | ERY | — | fms17, fms5, fms19 |
| 989* | 159/3/78 | >256 | 256 | CHL, GEN, KAN, RIF | aac(6′)-Ie-aph(2′′)-Ia, cat, tetM | — | esp, hyl | fms5, fms19 |
| 990 | 1/4-A/18 | >256 | 32 | RIF | ermB, tetM | ERY | hyl | fms5, fms19 |
| 991 | 3/1-A/18 | >256 | 32 | RIF | ermB, tetM | ERY | hyl | fms5, fms19 |
| 992 | 3/1-A/nd | >256 | 32 | RIF | ermB, tetM | ERY | hyl | fms5, fms19 |
| 993 | 3/1-A/nd | >256 | 32 | RIF | ermB, tetM | ERY | hyl | fms5, fms19 |
| 994 | 3/1-A/nd | >256 | 32 | RIF | ermB, tetM | ERY | hyl | fms5, fms19 |
| 995 | 3/1-A/nd | >256 | 24 | RIF, TET | ermB, tetM | ERY | hyl | fms5, fms19 |
| 996 | 3/1-A/nd | >256 | 32 | RIF, TET | ermB, tetM | ERY | hyl | fms5, fms19 |
| 3612 | 3/1-C/nd | >256 | 48 | GEN, RIF, TET | ermB, tetM | ERY | hyl | fms5, fms19 |
| 3613 | 3/1-C/nd | >256 | 32 | RIF, TET | ermB, tetM | ERY | hyl | fms5, fms19 |
| 3614 | 3/1-C/nd | >256 | 32 | RIF, TET | ermB, tetM | ERY | hyl | fms5, fms19 |
| 3615 | 3/1-C/nd | >256 | 32 | RIF, TET | ermB, tetM | ERY | hyl | fms5, fms19 |
| 3616 | 3/1-C/nd | >256 | 32 | RIF, TET | ermB, tetM | ERY | hyl | fms5, fms19 |
| 3617 | 3/1-C/nd | >256 | 32 | RIF, TET | ermB, tetM | ERY | hyl | fms5, fms19 |
| 3618 | 3/1-C/nd | >256 | 32 | RIF, TET | ermB, tetM | ERY | hyl | fms5, fms19 |
| 3620 | 10/5/262 | >256 | 48 | GEN, KAN, RIF, STR, TET | aac(6′)-Ie-aph(2′′)-Ia, aad6, ermB, tetM | ERY | hyl | fms17, fms5, fms19 |
| 3621 | 3/1-C/nd | >256 | 32 | RIF, TET | ermB, tetM | ERY | hyl | fms5, fms19 |
| 3622 | 3/1-B/18 | >256 | 32 | RIF, TET | ermB, tetM | ERY | hyl | fms5, fms19 |
| 3623 | 3/1-C/nd | >256 | 48 | RIF, TET | ermB, tetM | ERY | hyl | fms5, fms19 |
| 3624 | 10/5/262 | >256 | 48 | GEN, KAN, RIF, STR, TET | aac(6′)-Ie-aph(2′′)-Ia, aad6, ermB, tetM | no | — | fms17, fms5, fms19 |
| 3625 | 10/5/nd | >256 | 48 | GEN, KAN, RIF, STR, TET | aac(6′)-Ie-aph(2′′)-Ia, aad6, ermB, tetM | no | — | fms17, fms5, fms19 |
| 3626 | 10/5/nd | >256 | 48 | GEN, KAN, RIF, STR, TET | aac(6′)-Ie-aph(2′′)-Ia, aad6, ermB, tetM | no | — | fms17, fms5, fms19 |
| 3627 | 10/5/nd | >256 | 48 | GEN, KAN, RIF, STR, TET | aac(6′)-Ie-aph(2′′)-Ia, aad6, ermB, tetM | ERY | — | fms17, fms5, fms19 |
| 3628 | 3/1-C/nd | >256 | 64 | RIF, TET | ermB, tetM | ERY | hyl | fms5, fms19 |
| 3629 | 7/2-B/18 | >256 | 48 | GEN, KAN, TET | aac(6′)-Ie-aph(2′′)-Ia, ermB, tetM | ERY | hyl | fms17, fms5, fms19 |
| 3630 | 10/5/nd | >256 | 64 | GEN, KAN, RIF, STR, TET | aac(6′)-Ie-aph(2′′)-Ia, aad6, ermB, tetM | ERY, TET | — | fms17, fms5, fms19 |
| IO (N = 27) | CHL (1), GEN (9), KAN (8), STR (6), TET (20), RIF (26) | cat (1), aac(6′)-Ie-aph(2′′)-Ia (8), aad6, (6), ermB (26), tetM (26) | ERY (23), TET (1) | hyl (21), esp (1) | fms17 (8), fms5 (27), fms19 (27) | |||
|
| ||||||||
| Institute of hematology | ||||||||
| 3549 | 11/7-A/202 | >256 | 32 | GEN, KAN, RIF, TET | aac(6′)-Ie-aph(2′′)-Ia, aph(2′′)-Ib, ermB, tetM | ERY, GEN | esp, hyl | fms17, fms5, fms19 |
| 3550x | 7/8/18 | >256 | 48 | GEN, KAN, RIF, STR | aac(6′)-Ie-aph(2′′)-Ia, aph(2′′)-Ib, aph(3′)-IIIa, aad6, ermB | ERY | esp, hyl | fms17, fms5, fms19 |
| 3551 | 159/9/78 | >256 | 32 | GEN, KAN, RIF, STR | aac(6′)-Ie-aph(2′′)-Ia, aph(2′′)-Ib, aph(3′)IIIa, aad6, ermB | ERY | esp, hyl | fms17, fms19 |
| 3552* | 7/10/18 | >256 | >256 | KAN, RIF, STR | aph(3′)-IIIa, aad6, ermB, tetM | ERY | esp, hyl | fms17, fms5, fms19 |
| 3553 | 11/7-A/nd | >256 | 32 | GEN, KAN, RIF, TET | aac(6′)-Ie-aph(2′′)-Ia, aph(2′′)Ib, aph(3′)IIIa, ermB, tetM | ERY | esp, hyl | fms17, fms5, fms19 |
| 3554 | 159/6-A/192 | >256 | 48 | GEN, KAN, RIF, STR | aac(6′)-Ie-aph(2′′)-Ia, aph(2′′)-Ib, aph(3′)-IIIa, aad6, ermB | no | esp, hyl | fms17, fms5, fms19 |
| 3555 | 159/6-B/nd | >256 | 48 | GEN, KAN, RIF, STR | aac(6′)-Ie-aph(2′′)-Ia, aph(2′′)-Ib, aph(3′)-IIIa, aad6, ermB | no | esp, hyl | fms17, fms5, fms19 |
| 3556 | 159/6-C/nd | >256 | 32 | GEN, KAN, STR | aac(6′)-Ie-aph(2′′)-Ia, aph(3′)-IIIa, aad6, ermB | no | esp, hyl | fms17, fms5, fms19 |
| 3557x# | 296/11/17 | >256 | 48 | KAN, RIF | aph(3′)-IIIa, aad6, cat, ermB, tetM | ERY | esp, hyl | fms17, fms19 |
| 3558 | 159/6-A/nd | >256 | 48 | GEN, KAN, PEN | aac(6′)-Ie-aph(2′′)-Ia, aph(3′)-IIIa, aad6, ermB | no | esp, hyl | fms17, fms5, fms19 |
| 3559 | 159/6-D/nd | >256 | 48 | GEN, KAN, PEN | aac(6′)-Ie-aph(2′′)-Ia, aph(3′)-IIIa, aad6, ermB | no | esp, hyl | fms17, fms5, |
| 3560 | 1/7-B/18 | >256 | 48 | GEN, KAN, RIF, TET | aac(6′)-Ie-aph(2′′)-Ia, aph(3′)-IIIa, ermB, tetM | ERY | hyl | fms5, fms19 |
| 3561 | 11/4-C/202 | >256 | 32 | GEN, KAN, RIF, TET | aac(6′)-Ie-aph(2′′)-Ia, aph(2′′)-Ib, aph(3′)-IIIa, ermB, tetM | ERY | esp, hyl | fms17, fms5, |
| 3562# | 1/4-B/18 | >256 | 32 | GEN, KAN, RIF, TET | aac(6′)-Ie-aph(2′′)-Ia, aph(3′)-IIIa, ermB, tetM | no | hyl | fms5, fms19 |
| 3563 | 159/6-E/192 | >256 | 48 | GEN, KAN, RIF | aac(6′)-Ie-aph(2′′)-Ia, aph(2′′)-Ib, aph(3′)-IIIa, aad6, ermB | no | esp, hyl | fms17, fms5, fms19 |
| 3564y | 7/12/18 | >256 | 48 | GEN, KAN, RIF, TET | aac(6′)-Ie-aph(2′′)-Ia, aph(2′′)-Ib, aph(3′)-IIIa, ermB, tetM | ERY | esp, hyl | fms17, fms5, fms19 |
| 3567y# | 144/13/18 | >256 | 48 | GEN, KAN, RIF, TET | aac(6′)-Ie-aph(2′′)-Ia, aph(2′′)-Ib, ermB | ERY | hyl | fms17, fms5, fms19 |
| IH (N = 17) | GEN (15), KAN (17), STR (6), TET (7), RIF (15) | cat (1), aac(6′)-Ie-aph(2′′)-Ia (15), aph(2′′)-Ib (10), aph(3′)-IIIa (15), aad6 (10), ermB (17), tetM (8) | ERY (11), GEN (1) | hyl (17), esp (14) | fms17 (15), fms5 (15), fms19 (15) | |||
|
| ||||||||
| IO and IH (N = 44) | CHL (1), GEN (24), KAN (25), STR (12), TET (27), RIF (41) | cat (2), aac(6′)-Ie-aph(2′′)-Ia (23), aph(2′′)-Ib (10), aph(3′)-IIIa (15), aad6 (16), ermB (43), tetM (34) | ERY (34), TET (1), GEN (1) | hyl (38), esp (15) | fms17 (23), fms5 (42), fms19 (42) | |||
nd: not determined; no: no transconjugants obtained; two isolates with the prototype Tn1546 marked with an asterisk; #isolates from blood; aall isolates resistant to vancomycin, teicoplanin, penicillin, ampicillin, ciprofloxacin, erythromycin, and clindamycin; bfive isolates with tet(M) showed intermediate susceptibility to tetracycline and one isolate with tet(M) was susceptible to this compound, one tetracycline-resistant isolate (3567) was negative for the determinants tested; for four isolates with aad6 the MIC values for streptomycin increased (512 mg/L); one isolate with cat showed an intermediate resistance to chloramphenicol; call isolates were positive for the vanA gene; dall isolates positive for the pilA gene; x,yisolates from the same patients “X” and “Y”; RIF: rifampin; CHL: choramphenicol; GEN: gentamicin (HLGR); STR: streptomycin (HLSR); KAN: kanamycin (HLKR); TET: tetracycline. For the summarized results, the number of isolates is given in brackets.