Emergence of vanA-Type Vancomycin-Resistant Enterococcus faecium ST 78 Strain with a rep2-Type Plasmid Carrying a Tn1546-Like Element Isolated from a Urinary Tract Infection in China

Figures & data

Table 1 Minimal Inhibitory Concentrations (MICs) of the Antibiotics for Enterococcus faecium VRE1

Antibiotics	MIC (mg/L)
Penicillin ^b	>256
Ampicillin ^a	≥32
Streptomycin ^c	≥1024
Gentamicin ^c	32
Ciprofloxacin ^a	≥8
Levofloxacin ^a	≥8
Moxifloxacin ^a	≥8
Erythromycin ^a	≥8
Clindamycin ^a	≥8
Tetracycline ^b	0.5
Tigecycline ^b	0.125
Vancomycin ^b	>256
Teicoplanin ^b	128
Nitrofurantoin ^a	128
Linezolid ^a	2
Daptomycin ^c	8

Notes: ^aTested by an AST-GP67, ^bTested by the Etest method, ^cTested by standard broth microdilution tests.

Table 2 Antimicrobial Resistance and Virulence Encoded Genes of Enterococcus faecium VRE1

Antimicrobial Resistance Gene	Contig	Identity (%)	Position	Antimicrobial Resistance Category	Accession Number
msr(C)	VRE1	98.92	2,541,808.2543286	Macrolide	AY004350
aac(6’)-Ii	VRE1	99.64	2,136,309. 2136857	Aminoglycoside	L12710
ant(6)-Ia	pVRE1-VanA	100	110,643. 111551	Aminoglycoside	AF330699
aph(3’)-III	pVRE1-VanA	100	114,692. 115486	Aminoglycoside	M26832
vanA	pVRE1-VanA	100	86,599. 87630	Glycopeptide	M97297
Virulence Gene	Contig	Identity (%)	Position	Functional Annotation	Accession Number
acm	VRE1	100	2,147,759. 2149924	Collagen adhesin precursor	CP003351.1
espfm	VRE1	99.49	2,609,888. 2615815	Enterococcal surface protein	25,187,962

Figure 1 Circular representation of the vanA-encoding plasmid pVRE1-VanA.

Figure 2 Comparison of the homologous regions shared by different types of vanA-carrying plasmids. (A) Typical Tn1546 (E. faecium strain BM4147 plasmid pIP816, accession no. AM932524). (B) Tn1546-like element in this study (E. faecium strain VRE1 plasmid pVRE1-VanA, accession no. CP040742). (C) Similar Tn1546-like element with IS1216 inserted in the vanX-vanY intergenic region (E. faecium strain AUSMDU00004167 plasmid unnamed3, accession no. CP027500). (D) Tn1546-like element most closely related to that in the present study (E. faecium strain 2014-VREF-63 plasmid p63–1, accession no. CP019989).

Figure 3 Plasmid sequence alignment of vanA-carrying plasmids that revealed partial sequence identity to pVRE1-VanA. 3: E. faecium E7098 plasmid 3, accession no. LR135256. p2: E. faecium SC4 plasmid p2, accession no. CP025427. Unnamed2: E. faecium VB3025 plasmid unnamed2, accession no. CP040238. p63–1: E. faecium 2014-VREF-63 plasmid p63–1, accession no. CP019989. pEMSRR6: E. faecium SRR6 plasmid pEMSRR6, accession no. MG640601. Unnamed3: E. faecium AUSMDU00004167 plasmid unnamed3, accession no. CP027500.