Temporal changes in pulsed-field gel electrophoresis banding in vancomycin-resistant Enterococcus faecium and implications for outbreak investigations

Am J Infect Control. 2013 Apr;41(4):349-53. doi: 10.1016/j.ajic.2012.05.014. Epub 2012 Oct 24.

Abstract

Background: Patients are often screened with surveillance cultures to discern transmissions vs transformation of an isolate to vancomycin-resistant Enterococcus faecium. To determine the amount of time between which isolates could be considered genetically similar by pulsed-field gel electrophoresis, isolate change over time within single patients was studied.

Methods: A minimum of 4 isolates per patient, separated by at least 2 months, were collected from previously frozen stores. Visual comparison of banding patterns was conducted, and percent relatedness was calculated.

Results: Twenty-eight isolates from 6 patients were studied. No isolate differed by more than 3 bands before 150 days, and the average percent difference per band was 3.7%. The isolates diverged genetically as a linear function of number of bands over time (good model fit intrapatient r(2) = 0.42; poor model fit interpatient r(2) = 0.0062).

Conclusion: Trajectory of genetic variation appears to be isolate/patient specific; however, commonalities exist and tested isolates were relatively stable out to 150 days.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cross Infection / epidemiology*
  • Cross Infection / microbiology
  • Disease Outbreaks*
  • Electrophoresis, Gel, Pulsed-Field*
  • Enterococcus faecium / classification*
  • Enterococcus faecium / drug effects
  • Enterococcus faecium / genetics
  • Enterococcus faecium / isolation & purification
  • Genetic Variation
  • Genomic Instability
  • Genotype
  • Gram-Positive Bacterial Infections / epidemiology*
  • Gram-Positive Bacterial Infections / microbiology
  • Humans
  • Molecular Epidemiology / methods
  • Molecular Typing*
  • Vancomycin Resistance*