1.A Report of Vancomycin-susceptible, Teicoplanin-resistant Enterococcus faecalis ST6 in Malaysia
Loong, S.K. ; Che Mat Seri, N.A.A. ; Mahfodz, N.H. ; Akbar, S.Z. ; AbuBakar, S.
Tropical Biomedicine 2016;33(3):577-582
The ability to acquire antibiotic resistance and virulence has propelled Enterococcus
faecalis to become a major nosocomial pathogen. In Malaysia, data on the antibiotic resistance
determinants and virulence of Enterococcus circulating strains are still scarce. This study
aimed to assess the genotype of an E. faecalis isolate initially identified as Streptococcus
uberis, examine the antibiotic resistance genotypes, analyze the genetic variations within
Tn1546 and investigate the presence of virulence genes. The E. faecalis isolate was genetically
characterized using multilocus sequence typing (MLST). Minimum inhibitory concentrations
to vancomycin and teicoplanin were determined. Antibiotic resistance and other virulence
genes were amplified using nucleic acid polymerase chain reaction. Mapping of the Tn1546
transposon was performed and compared to the prototype sequences. The E. faecalis isolate
was found to have a MLST profile corresponding to sequence type 6. The isolate was resistant
to teicoplanin but susceptible to vancomycin. Its genome consisted the vanA and vanC1
genes. Novel genetic variations in the vanS, vanS-vanH intergenic region and vanY genes
were present and six virulence genes were detected. The detection of the vanC1 gene,
thought to be non-transferable, suggests the potential emergence of inter-species enterococcal
vanC1 gene transfer. The peculiar antibiotics resistance phenotype of this E. faecalis isolate
could be associated to the novel genetic variations found. This study highlights the presence
of E. faecalis belonging to the high-risk clonal complex with multiple virulence factors in
Malaysia.