sábado, 16 de junio de 2012

Enterococcus faecalis Clones in Poultry and in Humans with Urinary Tract Infections, Vietnam - Vol. 18 No. 7 - July 2012 - Emerging Infectious Disease journal - CDC

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Enterococcus faecalis Clones in Poultry and in Humans with Urinary Tract Infections, Vietnam - Vol. 18 No. 7 - July 2012 - Emerging Infectious Disease journal - CDC


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Bacteria articles
Volume 18, Number 7–July 2012

Volume 18, Number 7—July 2012

Research

Enterococcus faecalis Clones in Poultry and in Humans with Urinary Tract Infections, Vietnam

Louise Ladefoged Poulsen, Magne Bisgaard, Nguyen Thai Son, Nguyen Vu Trung, Hoang Manh An, and Anders DalsgaardComments to Author 
Author affiliations: University of Copenhagen, Copenhagen, Denmark (L.L. Poulsen, M. Bisgaard, A. Dalsgaard); Military Medical University, Ha Dong, Hanoi, Vietnam (N.T. Son, H.M. An); and Hanoi Medical University, Hanoi (N.V. Trung)
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Abstract

Enterococcus spp. as pathogens have increased, but the sources of infection often remain unclear. To investigate whether poultry might be a reservoir for E. faecalis–associated urinary tract infections (UTIs) in humans, we characterized E. faecalis isolates from patients in Vietnam with UTIs during January 2008–January 2010 and poultry living in close contact with them by multilocus sequence typing (MLST), pulsed-field gel electrophoresis, analysis of antimicrobial drug susceptibility patterns, and sequencing of virulence genes. In 7 (23%) of 31 UTI cases, we detected identical MLST, indistinguishable or closely related pulsed-field gel electrophoresis patterns, and similar antimicrobial drug susceptibility patterns. Isolates from urine and poultry showed identical virulence gene profiles, except for 1 variation, and individual genes showed identical sequences. The homology of isolates from urine and poultry further indicates the zoonotic potential and global spread of E. faecalis sequence type 16, which recently was reported in humans with endocarditis and in pigs in Denmark.
Enterococci are commensals of the human and animal gastrointestinal tract and opportunistic pathogens that cause urinary tract infections (UTIs), endocarditis, and sepsis (1). Nosocomial infections caused by enterococci have increased; these pathogens are now the third most common at hospitals after Escherichia coli and Staphylococcus aureus (2); and enterococci are frequently recorded as the cause of UTIs, wound infections, bacteremia, and endocarditis (36).

The sources of enterococcal infections in humans are not clear, but animal reservoirs have been suggested (2,4,79). A study comparing enterococcal isolates from 4 European countries and the United States demonstrated that E. faecalis isolated from pigs in Portugal had pulsed-field gel electrophoresis (PFGE) patterns identical to those of multidrug-resistant isolates at hospitals in Spain, Italy, and Portugal, all of which were shown by multilocus sequence typing (MLST) to belong to sequence type (ST) 6 (7). In Denmark, high-level gentamicin-resistant E. faecalis of ST16 with an identical PFGE pattern was isolated from pigs and from humans with endocarditis (9). Identical and closely related PFGE patterns were demonstrated by isolates from humans and from pork and chicken meat in the United States, all of which contained high-level gentamicin-resistant genes (4). Our objective was to characterize epidemiologically related E. faecalis isolated from humans with UTIs and from poultry living in the same households in Vietnam to evaluate the zoonotic potential of E. faecalis.

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