Outbreak of vancomycin-resistant Enterococcus faecium ST1133 in paediatric patients with acute lymphoblastic leukaemia from southern Brazil
ABSTRACT: Objectives: We aimed to investigate an outbreak of vancomycin-resistant Enterococcus faecium (VREfm) in paediatric patients from Hospital Pequeno Príncipe. The susceptibility profile was determined, and whole-genome sequencing (WGS) was used to analyse the genetic context of the strains....
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| Format: | Article |
| Language: | English |
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Elsevier
2024-03-01
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| Series: | Journal of Global Antimicrobial Resistance |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213716523001984 |
| _version_ | 1797249171919470592 |
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| author | Thaís Muniz Vasconcelos Dany Mesa Luiza Souza Rodrigues Érika Medeiros dos Santos Damaris Krul Adriele Celine Siqueira Renata Barbosa Vahia de Abreu Fábio de Araújo Motta Danieli Conte Libera Maria Dalla-Costa |
| author_facet | Thaís Muniz Vasconcelos Dany Mesa Luiza Souza Rodrigues Érika Medeiros dos Santos Damaris Krul Adriele Celine Siqueira Renata Barbosa Vahia de Abreu Fábio de Araújo Motta Danieli Conte Libera Maria Dalla-Costa |
| author_sort | Thaís Muniz Vasconcelos |
| collection | DOAJ |
| description | ABSTRACT: Objectives: We aimed to investigate an outbreak of vancomycin-resistant Enterococcus faecium (VREfm) in paediatric patients from Hospital Pequeno Príncipe. The susceptibility profile was determined, and whole-genome sequencing (WGS) was used to analyse the genetic context of the strains. Methods: Five VREfm isolates were recovered from sterile sites and surveillance cultures of two paediatric patients with acute lymphoblastic leukaemia. Species identification was performed using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS), and the minimum inhibitory concentration (MIC) was assessed according to the European Committee for Antimicrobial Susceptibility Testing (EUCAST). WGS was performed to analyse the genetic context of virulence and resistance genes, and in silico multilocus sequence typing was performed to identify the sequence typing of the strains. Results: High-level vancomycin resistance was observed in all isolates (≥256 mg/L). WGS revealed the presence of mobile genetic elements, such as plasmids (rep2, rep11a, repUS15, rep17, and rep18a), insertion sequences, and phages. Multiple resistance genes (aac(6′)-aph(2ʺ), dfrG, ermB, and vanA) and virulence genes (acm and efaAfm) were identified. All the isolates were assigned to ST117 (ST1133 – via a novel MLST), an important epidemic lineage associated with nosocomial infections and outbreaks. Conclusion: Our results show that the ST117 (ST1133) VREfm isolates are circulating in paediatric patients, which raises a great concern. The development of new drugs as well as the implementation of an antimicrobial stewardship program are necessary for their correct management, limiting the spread of resistance in oncohematological patients. |
| first_indexed | 2024-03-08T18:18:54Z |
| format | Article |
| id | doaj.art-c5345dc6e0f7430ba15cda0a27a45429 |
| institution | Directory Open Access Journal |
| issn | 2213-7165 |
| language | English |
| last_indexed | 2024-04-24T20:26:15Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Global Antimicrobial Resistance |
| spelling | doaj.art-c5345dc6e0f7430ba15cda0a27a454292024-03-22T05:39:20ZengElsevierJournal of Global Antimicrobial Resistance2213-71652024-03-01364144Outbreak of vancomycin-resistant Enterococcus faecium ST1133 in paediatric patients with acute lymphoblastic leukaemia from southern BrazilThaís Muniz Vasconcelos0Dany Mesa1Luiza Souza Rodrigues2Érika Medeiros dos Santos3Damaris Krul4Adriele Celine Siqueira5Renata Barbosa Vahia de Abreu6Fábio de Araújo Motta7Danieli Conte8Libera Maria Dalla-Costa9Faculdades Pequeno Príncipe (FPP), Curitiba, Paraná, Brazil; Instituto de Pesquisa Pelé Pequeno Príncipe (IPPPP), Curitiba, Paraná, BrazilFaculdades Pequeno Príncipe (FPP), Curitiba, Paraná, Brazil; Instituto de Pesquisa Pelé Pequeno Príncipe (IPPPP), Curitiba, Paraná, BrazilInstituto de Pesquisa Pelé Pequeno Príncipe (IPPPP), Curitiba, Paraná, BrazilFaculdades Pequeno Príncipe (FPP), Curitiba, Paraná, Brazil; Instituto de Pesquisa Pelé Pequeno Príncipe (IPPPP), Curitiba, Paraná, Brazil; Hospital Pequeno Príncipe (HPP), Curitiba, Paraná, BrazilFaculdades Pequeno Príncipe (FPP), Curitiba, Paraná, Brazil; Instituto de Pesquisa Pelé Pequeno Príncipe (IPPPP), Curitiba, Paraná, BrazilFaculdades Pequeno Príncipe (FPP), Curitiba, Paraná, Brazil; Instituto de Pesquisa Pelé Pequeno Príncipe (IPPPP), Curitiba, Paraná, BrazilFaculdades Pequeno Príncipe (FPP), Curitiba, Paraná, BrazilHospital Pequeno Príncipe (HPP), Curitiba, Paraná, BrazilFaculdades Pequeno Príncipe (FPP), Curitiba, Paraná, Brazil; Instituto de Pesquisa Pelé Pequeno Príncipe (IPPPP), Curitiba, Paraná, BrazilFaculdades Pequeno Príncipe (FPP), Curitiba, Paraná, Brazil; Instituto de Pesquisa Pelé Pequeno Príncipe (IPPPP), Curitiba, Paraná, Brazil; Corresponding author. Instituto de Pesquisa Pelé Pequeno Príncipe, Av. Silva Jardim, 1632 – Rebouças, CEP 80250-060 Curitiba, PR Brazil.ABSTRACT: Objectives: We aimed to investigate an outbreak of vancomycin-resistant Enterococcus faecium (VREfm) in paediatric patients from Hospital Pequeno Príncipe. The susceptibility profile was determined, and whole-genome sequencing (WGS) was used to analyse the genetic context of the strains. Methods: Five VREfm isolates were recovered from sterile sites and surveillance cultures of two paediatric patients with acute lymphoblastic leukaemia. Species identification was performed using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS), and the minimum inhibitory concentration (MIC) was assessed according to the European Committee for Antimicrobial Susceptibility Testing (EUCAST). WGS was performed to analyse the genetic context of virulence and resistance genes, and in silico multilocus sequence typing was performed to identify the sequence typing of the strains. Results: High-level vancomycin resistance was observed in all isolates (≥256 mg/L). WGS revealed the presence of mobile genetic elements, such as plasmids (rep2, rep11a, repUS15, rep17, and rep18a), insertion sequences, and phages. Multiple resistance genes (aac(6′)-aph(2ʺ), dfrG, ermB, and vanA) and virulence genes (acm and efaAfm) were identified. All the isolates were assigned to ST117 (ST1133 – via a novel MLST), an important epidemic lineage associated with nosocomial infections and outbreaks. Conclusion: Our results show that the ST117 (ST1133) VREfm isolates are circulating in paediatric patients, which raises a great concern. The development of new drugs as well as the implementation of an antimicrobial stewardship program are necessary for their correct management, limiting the spread of resistance in oncohematological patients.http://www.sciencedirect.com/science/article/pii/S2213716523001984Vancomycin-resistant Enterococcus faeciumAntibioticsAcute lymphoblastic leukaemiaST117 (ST1133)Paediatrics |
| spellingShingle | Thaís Muniz Vasconcelos Dany Mesa Luiza Souza Rodrigues Érika Medeiros dos Santos Damaris Krul Adriele Celine Siqueira Renata Barbosa Vahia de Abreu Fábio de Araújo Motta Danieli Conte Libera Maria Dalla-Costa Outbreak of vancomycin-resistant Enterococcus faecium ST1133 in paediatric patients with acute lymphoblastic leukaemia from southern Brazil Journal of Global Antimicrobial Resistance Vancomycin-resistant Enterococcus faecium Antibiotics Acute lymphoblastic leukaemia ST117 (ST1133) Paediatrics |
| title | Outbreak of vancomycin-resistant Enterococcus faecium ST1133 in paediatric patients with acute lymphoblastic leukaemia from southern Brazil |
| title_full | Outbreak of vancomycin-resistant Enterococcus faecium ST1133 in paediatric patients with acute lymphoblastic leukaemia from southern Brazil |
| title_fullStr | Outbreak of vancomycin-resistant Enterococcus faecium ST1133 in paediatric patients with acute lymphoblastic leukaemia from southern Brazil |
| title_full_unstemmed | Outbreak of vancomycin-resistant Enterococcus faecium ST1133 in paediatric patients with acute lymphoblastic leukaemia from southern Brazil |
| title_short | Outbreak of vancomycin-resistant Enterococcus faecium ST1133 in paediatric patients with acute lymphoblastic leukaemia from southern Brazil |
| title_sort | outbreak of vancomycin resistant enterococcus faecium st1133 in paediatric patients with acute lymphoblastic leukaemia from southern brazil |
| topic | Vancomycin-resistant Enterococcus faecium Antibiotics Acute lymphoblastic leukaemia ST117 (ST1133) Paediatrics |
| url | http://www.sciencedirect.com/science/article/pii/S2213716523001984 |
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