TABLE 2.
Characteristics of 25 vanA-positive high-level resistant enterococcia isolated from infected and colonized hospital patients and from fecal samples of outpatients
| Species | Strain (lane number in Fig. 1) | Origin of strain
|
Resistance patternb
|
SmaI MRA pattern | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Town (state) | Ward | Material | AMP | GEN | STR | CIP | Q-D | |||
| E. faecium | UW 400 (1) | N (Bavaria) | ICU | URTc | R | R | R | R | S | I |
| UW 805 (2) | N (Bavaria) | Nephrology | Blood | R | R | R | R | S | Ia | |
| UW 901 (3) | D1 (Hesse) | Dialysis unit | Wound | R | S | S | R | S | II | |
| UW 931 (4) | G (Lower Saxony) | ICU | BALc | R | S | S | R | S | II | |
| UW 1503 (5) | L (North Rhine-Westphalia) | n.d.c | Urine | R | S | S | R | S | II | |
| UW 1504 (6) | L (North Rhine-Westphalia) | Medicine | Bile | R | S | S | R | S | II | |
| UW 1505 (7) | L (North Rhine-Westphalia) | Surgery | Wound | R | S | S | R | S | II | |
| UW 1511 (8) | L (North Rhine-Westphalia) | Surgery | Wound | S | S | S | S | S | II | |
| UW 1512 (9) | L (North Rhine-Westphalia) | Surgery | Urine | R | S | S | R | S | II | |
| UW 1508 (10) | D2 (North Rhine-Westphalia) | Pediatrics | Urine | R | S | S | R | S | V | |
| UW 1510 (11) | A (North Rhine-Westphalia) | Medicine | Urine | R | S | R | R | S | III | |
| UW 1506 (12) | A (North Rhine-Westphalia) | Medicine | Wound | S | S | R | I | S | VI | |
| UW 1497 (13) | A (North Rhine-Westphalia) | Community | Stool | I | S | R | R | S | VIII | |
| UW 1495 (14) | A (North Rhine-Westphalia) | Community | Stool | I | S | R | I | S | IX | |
| UW 1498 (15) | A (North Rhine-Westphalia) | Community | Stool | I | S | R | R | S | IV | |
| UW 1501 (16) | A (North Rhine-Westphalia) | Community | Stool | I | S | S | I | S | VIII | |
| UW 1496 (17) | A (North Rhine-Westphalia) | Community | Stool | S | S | S | R | S | VII | |
| UW 1502 (18) | A (North Rhine-Westphalia) | Community | Stool | S | S | R | I | S | VIIIa | |
| UW 1499 (19) | A (North Rhine-Westphalia) | Community | Stool | S | S | S | I | S | VIIIb | |
| UW 1493 (20) | A (North Rhine-Westphalia) | Community | Stool | S | S | S | I | S | VIIIc | |
| UW 1494 (21) | A (North Rhine-Westphalia) | Community | Stool | S | S | S | R | S | X | |
| E. durans | UW 1492 (22) | A (North Rhine-Westphalia) | Community | Stool | S | S | S | S | S | n.d.c |
| E. faecalis | UW 1507 (23) | E (North Rhine-Westphalia) | Surgery | Blood | S | S | S | I | R | 1 |
| UW 1513 (24) | A (North Rhine-Westphalia) | Medicine | Wound | S | S | S | I | R | 2 | |
| UW 1509 (25) | D2 (North Rhine-Westphalia) | Medicine | Urine | S | S | S | R | R | 3 | |
According to the MICs, all enterococcal strains included were resistant to penicillin (≥16 mg/liter), erythromycin A (≥8 mg/liter), clindamycin (≥4 mg/liter), vancomycin (≥32 mg/liter), and teicoplanin (≥32 mg/liter). In all VRE the vanA gene and VanA protein were detectable.
Susceptibility (S), resistance (R), and intermediate (I) sensitivity were defined according to MIC breakpoints from the National Committee for Clinical Laboratory Standards (agar dilution method): ampicillin (AMP), ≤8 mg/liter (≥16 mg/liter); gentamicin (GEN), ≤500 mg/liter (>500 mg/liter); streptomycin (STR), ≤2,000 mg/liter (>2,000 mg/liter); ciprofloxacin (CIP), ≤1 mg/liter (≥4 mg/liter); and quinupristin-dalfopristin (Q-D), ≤1 mg/liter (≥4 mg/liter).
URT, upper respiratory tract; BAL, bronchoalveolar lavage fluid; n.d., no data.