Characteristics and trends of clinical strains of glycopeptide- and/or linezolid-resistant enterococci isolated in France, 2006–2020

Introduction - Numerous outbreaks involving glycopeptide-resistant enterococci (GRE) have been reported in France and around the world. In addition, the emergence of linezolid-resistant enterococci (LRE) has recently been reported. The objective of this study is to describe the main characteristics of ERG and LRE strains isolated in France and received at the National Reference Center for Antibiotic Resistance between 2006 and 2020. Methods - All strains received were characterized phenotypically (MALDI-TOF, susceptibility testing, MIC) and genotypically (qPCR, WGS). The typing and comparison of ERG strains were performed using various techniques over time (pulsed-field gel electrophoresis, rep-PCR, comparative genomic analysis, or Fourier transform infrared spectroscopy). Results - Of the 6,311 ERG strains received between 2006 and 2020, the vast majority belonged to the species E. faecium (91.8–98.3%), followed by E. faecalis (0.8–7.9%). The vanA gene was predominant (74.9%), followed by the vanB gene (23.8%). A vast majority (>95%) of E. faecium strains belonged to clonal complex (CC) 17. Since 2017, a significant increase in ERL has been observed, linked to the spread in certain regions of epidemic strains exhibiting chromosomal resistance, as well as to the acquisition of plasmid genes (notably optrA and poxtA) by non-clonal strains. Molecular typing demonstrated that many ERG clones (primarily E. faecium) were sporadic, while certain hyper-epidemic clones (isolated from at least 5 patients) were detected in several different institutions/cities with locoregional spread. Conclusion - The majority of ERG strains circulating in France are E. faecium strains adapted to the hospital environment (CC17) and carrying the vanA operon. There is also the emergence of ERL strains, which must be closely monitored.

Author(s): Zouari Asma, Auger Gabriel, Nogues Sophie, Collet Anaïs, Lecourt Maxime, Guérin François, Cattoir Vincent

Publishing year: 2021

Pages: 359-364

Weekly Epidemiological Bulletin, 2021, n° 18-19, p. 359-364

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