Molecular Genetic Profiling of Clinical and Foodborne Strains of Enterococci with High Level Resistance to Gentamicin and Vancomycin

Enterococci often acquire antimicrobial resistance through horizontal gene transfer. Relatedness between enterococci with high level resistance to gentamicin and vancomycin isolated from humans, food and hospital environment in Tandil County (Argentina) was investigated. PCR amplification for species determination was carried out. Resistance to seven antimicrobials was studied; virulence genes (esp, cylA), vancomycin and gentamicin resistance genes were investigated. In the isolates with high level antimicrobial resistance (gentamicin, vancomycin), pulse-field gel electrophoresis was performed. Vancomycin-resistant E. faecium (n:13) were recovered from human, food and hospital environment samples. All the isolates expressed high-level vancomycin and teicoplanin (vanA genotype), as well high-level gentamicin and streptomycin resistance. Vancomycin-resistant E. faecium were distributed among seven clonal types; esp gene was detected in clinical strains. There was no clonal relationship with food vanA E. faecium, but these strains could pose a risk in intra/inter genus transfer of vanA determinant to human-adapted strains. High-level gentamicin resistant E. faecalis (n:7) were recovered from human and food samples. Glycopeptide resistance was not observed; cylA gene was detected in most of the clinical high-level gentamicin resistant E. faecalis isolates. PFGE patterns showed four clonal types in high-level gentamicin resistant E. faecalis strains; there was demonstrated clonal relatedness between isolates from different origin. In Argentina, this is the first study showing a clonal relationship between high-level gentamicin resistant E. faecalis isolated from food and humans. These results encourage the study of dissemination of clonal complexes with mobile resistance genes.