A Phenotypically Silent <italic toggle="yes">vanB2</italic> Operon Carried on a Tn<italic toggle="yes">1549</italic>-Like Element in <named-content content-type="genus-species">Clostridium difficile</named-content>

ABSTRACT In the last decade, Clostridium difficile infection (CDI) has reached an epidemic state with increasing incidence and severity in both health care and community settings. Vancomycin is an important first-line therapy for CDI, and the emergence of resistance would have significant clinical c...

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Autores principales:	Daniel R. Knight, Grace O. Androga, Susan A. Ballard, Benjamin P. Howden, Thomas V. Riley
Formato:	article
Lenguaje:	EN
Publicado:	American Society for Microbiology 2016
Materias:	antimicrobial resistance Clostridium difficile infection mobile genetic element vanB Microbiology QR1-502
Acceso en línea:	https://doaj.org/article/44c5ec326332464bb198117c863accc7
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spelling	oai:doaj.org-article:44c5ec326332464bb198117c863accc72021-11-15T15:21:14ZA Phenotypically Silent <italic toggle="yes">vanB2</italic> Operon Carried on a Tn<italic toggle="yes">1549</italic>-Like Element in <named-content content-type="genus-species">Clostridium difficile</named-content>10.1128/mSphere.00177-162379-5042https://doaj.org/article/44c5ec326332464bb198117c863accc72016-08-01T00:00:00Zhttps://journals.asm.org/doi/10.1128/mSphere.00177-16https://doaj.org/toc/2379-5042ABSTRACT In the last decade, Clostridium difficile infection (CDI) has reached an epidemic state with increasing incidence and severity in both health care and community settings. Vancomycin is an important first-line therapy for CDI, and the emergence of resistance would have significant clinical consequences. In this study, we describe for the first time a vanB2 vancomycin resistance operon in C. difficile, isolated from an Australian veal calf at slaughter. The operon was carried on an ~42-kb element showing significant homology and synteny to Tn1549, a conjugative transposon linked with the emergence and global dissemination of vancomycin-resistant enterococci (VRE). Notably, the C. difficile strain did not show any reduced susceptibility to vancomycin in vitro (MIC, 1 mg/liter), possibly as a result of an aberrant vanRB gene. As observed for other anaerobic species of the animal gut microbiota, C. difficile may be a reservoir of clinically important vancomycin resistance genes. IMPORTANCE In an era when the development of new antimicrobial drugs is slow, vancomycin remains the preferred antimicrobial therapy for Clostridium difficile infection (CDI), the most important health care-related infection in the world today. The emergence of resistance to vancomycin would have significant consequences in relation to treating patients with CDI. In this paper, we describe for the first time a complete set of vancomycin resistance genes in C. difficile. The genes were very similar to genes found in vancomycin-resistant enterococci (VRE) that were associated with the emergence and global dissemination of this organism. Fortunately, the C. difficile strain did not show any reduced susceptibility to vancomycin in vitro (MIC, 1 mg/liter), possibly because of a small difference in one gene. However, this observation signals that we may be very close to seeing a fully vancomycin-resistant strain of C. difficile.Daniel R. KnightGrace O. AndrogaSusan A. BallardBenjamin P. HowdenThomas V. RileyAmerican Society for Microbiologyarticleantimicrobial resistanceClostridium difficile infectionmobile genetic elementvanBMicrobiologyQR1-502ENmSphere, Vol 1, Iss 4 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	antimicrobial resistance Clostridium difficile infection mobile genetic element vanB Microbiology QR1-502
spellingShingle	antimicrobial resistance Clostridium difficile infection mobile genetic element vanB Microbiology QR1-502 Daniel R. Knight Grace O. Androga Susan A. Ballard Benjamin P. Howden Thomas V. Riley A Phenotypically Silent <italic toggle="yes">vanB2</italic> Operon Carried on a Tn<italic toggle="yes">1549</italic>-Like Element in <named-content content-type="genus-species">Clostridium difficile</named-content>
description	ABSTRACT In the last decade, Clostridium difficile infection (CDI) has reached an epidemic state with increasing incidence and severity in both health care and community settings. Vancomycin is an important first-line therapy for CDI, and the emergence of resistance would have significant clinical consequences. In this study, we describe for the first time a vanB2 vancomycin resistance operon in C. difficile, isolated from an Australian veal calf at slaughter. The operon was carried on an ~42-kb element showing significant homology and synteny to Tn1549, a conjugative transposon linked with the emergence and global dissemination of vancomycin-resistant enterococci (VRE). Notably, the C. difficile strain did not show any reduced susceptibility to vancomycin in vitro (MIC, 1 mg/liter), possibly as a result of an aberrant vanRB gene. As observed for other anaerobic species of the animal gut microbiota, C. difficile may be a reservoir of clinically important vancomycin resistance genes. IMPORTANCE In an era when the development of new antimicrobial drugs is slow, vancomycin remains the preferred antimicrobial therapy for Clostridium difficile infection (CDI), the most important health care-related infection in the world today. The emergence of resistance to vancomycin would have significant consequences in relation to treating patients with CDI. In this paper, we describe for the first time a complete set of vancomycin resistance genes in C. difficile. The genes were very similar to genes found in vancomycin-resistant enterococci (VRE) that were associated with the emergence and global dissemination of this organism. Fortunately, the C. difficile strain did not show any reduced susceptibility to vancomycin in vitro (MIC, 1 mg/liter), possibly because of a small difference in one gene. However, this observation signals that we may be very close to seeing a fully vancomycin-resistant strain of C. difficile.
format	article
author	Daniel R. Knight Grace O. Androga Susan A. Ballard Benjamin P. Howden Thomas V. Riley
author_facet	Daniel R. Knight Grace O. Androga Susan A. Ballard Benjamin P. Howden Thomas V. Riley
author_sort	Daniel R. Knight
title	A Phenotypically Silent <italic toggle="yes">vanB2</italic> Operon Carried on a Tn<italic toggle="yes">1549</italic>-Like Element in <named-content content-type="genus-species">Clostridium difficile</named-content>
title_short	A Phenotypically Silent <italic toggle="yes">vanB2</italic> Operon Carried on a Tn<italic toggle="yes">1549</italic>-Like Element in <named-content content-type="genus-species">Clostridium difficile</named-content>
title_full	A Phenotypically Silent <italic toggle="yes">vanB2</italic> Operon Carried on a Tn<italic toggle="yes">1549</italic>-Like Element in <named-content content-type="genus-species">Clostridium difficile</named-content>
title_fullStr	A Phenotypically Silent <italic toggle="yes">vanB2</italic> Operon Carried on a Tn<italic toggle="yes">1549</italic>-Like Element in <named-content content-type="genus-species">Clostridium difficile</named-content>
title_full_unstemmed	A Phenotypically Silent <italic toggle="yes">vanB2</italic> Operon Carried on a Tn<italic toggle="yes">1549</italic>-Like Element in <named-content content-type="genus-species">Clostridium difficile</named-content>
title_sort	phenotypically silent <italic toggle="yes">vanb2</italic> operon carried on a tn<italic toggle="yes">1549</italic>-like element in <named-content content-type="genus-species">clostridium difficile</named-content>
publisher	American Society for Microbiology
publishDate	2016
url	https://doaj.org/article/44c5ec326332464bb198117c863accc7
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A Phenotypically Silent <italic toggle="yes">vanB2</italic> Operon Carried on a Tn<italic toggle="yes">1549</italic>-Like Element in <named-content content-type="genus-species">Clostridium difficile</named-content>

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