Table I
Relationship between MRFP types and antimicrobial susceptibility profiles of vancomycin-resistant Enterococcus faecium isolates (n = 22).
| MRFP pattern | Number of isolates/patientsa | Isolate code | Hospital wardb | Gender | Age | Date of admission | Diagnostics | Short-term outcome | Susceptibility profilec | Resistance pattern | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AMP | CIP | GN | TEC | VA | LNZ | TGC | ||||||||||
| Pl | 2 | EN2 | ICU | female | 79 | 25.08.2021 | pneumonia, cerebral infarction | died | R | R | S | R | R | S | S | I |
| EN5 | IICU | male | 57 | 06.10.2021 | pneumonia, chronic obstructive pulmonary disease | died | R | R | R | R | R | S | S | II | ||
| P2 | 7 | EN1 | ICU | female | 40 | 20.08.2021 | pneumonia septicemia, encephalopathy | died | R | R | S | R | R | S | S | I |
| EN4 | ICU | female | 82 | 22.10.2021 | pneumonia, cerebrovascular disease, heart failure | recovered | R | R | R | R | R | S | S | II | ||
| EN9 | ICU | female | 63 | 11.11.2021 | cerebrovascular disease, coronary artery disease | died | R | R | R | R | R | S | S | II | ||
| EN10 | ICU | male | 70 | 16.02.2022 | pneumonia chronic obstructive pulmonary disease, heart failure | died | R | R | R | R | R | S | S | II | ||
| EN14 | ICU | male | 29 | 26.03.2022 | pneumonia, epilepsy | recovered | R | R | R | R | R | S | S | II | ||
| EN15 | NU | male | 71 | 03.04.2022 | pneumonia, cerebrovascular disease, acute renal failure | died | R | R | S | R | R | S | S | I | ||
| EN20 | ICU | female | 52 | 26.06.2022 | pneumonia, septicemia, urinary tract infection | died | R | R | R | R | R | S | S | II | ||
| P3 | 2 | EN21 | ICU | male | 71 | 16.09.2021 | acute renal failure, hypertension | died | R | R | R | R | R | S | S | II |
| EN22 | ICU | male | 68 | 22.09.2021 | pneumonia, atherosclerotic heart disease | died | R | R | R | R | R | S | S | II | ||
| P4 | 1 | EN3 | IICU | female | 77 | 22.10.2021 | pneumonia, cerebrovascular disease | died | R | R | R | R | R | S | S | II |
| P4a | 1 | EN6 | ICU | female | 87 | 27.11.2021 | pneumonia, abdominal pain | recovered | R | R | R | R | R | S | S | II |
| P5 | 1 | EN7 | IICU | female | 84 | 20.09.2021 | chronic kidney failure, liver cancer | recovered | R | R | R | R | R | S | S | II |
| P6 | 1 | EN16 | ICU | male | 79 | 11.06.2022 | chronic obstructive pulmonary disease, heart failure | died | R | R | R | R | R | S | S | II |
| P6a | 1 | EN8 | IICU | female | 62 | 15.08.2021 | diabetes mellitus, urinary tract infection | recovered | R | R | R | R | R | S | S | II |
| P7 | 2 | ENI 8 | IICU | male | 62 | 24.02.2022 | syncope, cerebrovascular disease | recovered | R | R | R | R | R | S | S | II |
| EN19 | IICU | male | 64 | 29.02.2022 | syncope, diabetes mellitus, hypertension | recovered | R | R | R | R | R | S | S | II | ||
| P8 | 2 | EN11 | ICU | male | 64 | 11.02.2022 | pneumonia, cerebrovascular disease, heart failure | died | R | R | R | R | R | S | S | II |
| EN12 | ICU | male | 93 | 23.02.2022 | pneumonia, chronic obstructive pulmonary disease | died | R | R | S | R | R | S | S | I | ||
| P8a | 1 | EN13 | ICU | female | 77 | 10.01.2022 | pneumonia, cerebrovascular disease | died | R | R | R | R | R | S | S | II |
| P9 | 1 | EN17 | ICU | male | 74 | 20.06.2022 | liver failure, chronic obstructive pulmonary disease | died | R | R | R | R | R | S | S | II |
1a – isolates with identical antimicrobial sensitivity and macro-restriction fragment pattern (MRFP)
1b – ICU – intensive care unit, IICU – internal medicine intensive care unit, NU – neurointensive care unit
1c – breakpoints to discriminate between susceptible (S), intermediate (I), and resistant (R) were ≤ 4, > 8 μg/ml for ampicillin (AMP), ≤ 4, > 4 μg/ml for ciprofloxacin (CIP), ≤ 128, > 128 for gentamycin (GN), ≤ 2, > 2 μg/ml for teicoplanin (TEC), ≤ 4, > 4 μg/ml for vancomycin (VA), ≤ 4, > 4 μg/ml for linezolid (LNZ), ≤ 0.25, 0.25 μg/ml for tigecycline (TGC) (EUCAST 2018)
Fig. 1.
Dendrogram showing the MRFP patterns of 22 vancomycin-resistant Enterococcus faecium isolates, denoted MRFP types P1 to P9, obtained from 22 patients digested with the SmaI restriction enzyme. The dendrogram was constructed with the BioNumerics v6.6 (Applied Maths, Belgium) program, with the Dice coefficient setting tolerance and optimization at 1.0% and 2.0% with 95% similarity cut-off value. Hospital ward: ICU – intensive care unit, IICU – internal medicine intensive care unit, NU – neurointensive care unit.