TABLE 1.
Strain | Resistance classificationa | Hospital | Patient | Age (yrs) | Underlying disease | Isolation date (mo-day-yr) | Isolation site | Antibiotic use | Interval vancomycin treatment and VanDb | MICs (mg/liter) |
Variation in Ddlc | Variation in VanSc | Size of genomic island (bp) | ||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Vancomycin | Teicoplanin | Ampicillin | |||||||||||||
E7962 | VRE | 1 | A | 73 | Acute myeloid leukemia | 11-25-2013 | Rectum | Vancomycin cotrimoxazole, ciprofloxacin | Unknown | 16 | <1 | >256 | S185F | S57R, K169E, T170P, V280L | 185,412 |
E8043 | VRE | 2 | B | 57 | Acute lymphoid leukemia | 3-24-2014 | Rectum | vancomycin | Unknown | 16 | <1 | >256 | Insertion 2 aa at pos. 280 | S57R, A165V, V280L | 168,512 |
E9242 | VRE | 2 | C | 18 | Acute lymphoid leukemia | 3-31-2016 | Rectum | Cotrimoxazole, ciprofloxacin | Unknown | 256 | 4 | >256 | Δ2 bp at pos. 319 | K308Q | 144,229 |
E9352d | ARE | 12-9-2012 | Blood | Amoxicillin-clavulanic acid, cefotaxime, ciprofloxacin, metronidazole, vancomycin | NA | <1 | <1 | >256 | Normal | NA | |||||
E9353d | ARE | 3 | D | 65 | Cardiovascular disease, cholangitis | 12-27-2012 | Blood | NA | <1 | <1 | >256 | Normal | NA | ||
E8429d | VRE | 1-22-2013 | Rectum | 43 days | 256 | 2 | >256 | Δ1 bp at pos. 165 | S57R, A68V, K308Q, V280L | 120,918 | |||||
E9354d | VRE | 1-27-2013 | Rectum | 48 days | 256 | 2 | >256 | Δ4 aa at pos. 280 | S57R, A68V, K308Q, V280L | 120,844 | |||||
E9641 | VRE | 4 | E | 63 | Non-Hodgkin lymphoma | 2-27-2017 | Rectum | Ciprofloxacin, ceftazidime, piperacillin-tazobactam, vancomycin | 4 mo | 8 | <0.5 | >256 | S185F | S57R, V280L | 168,541 |
VRE, vancomycin-resistant E. faecium; ARE, ampicillin-resistant E. faecium.
NA, not available.
Indicated positions are based on amino acid (aa) sequence for Ddl (d-Ala-d-Ala ligase) and VanS (vancomycin sensor protein).
These four strains were isolated from the same patient at different time points.