Identification of high-risk enterococcal clonal complexes: global dispersion and antibiotic resistance

Curr Opin Microbiol. 2006 Oct;9(5):454-60. doi: 10.1016/j.mib.2006.07.001. Epub 2006 Aug 1.


Vancomycin-resistant Enterococcus faecium spread dramatically in hospital settings in the USA in the 1990s and reached endemicity at the turn of the century. Similarly, rising prevalence rates are currently observed in several European countries, with prevalence rates of greater than 10% reported in seven of these. On the basis of multilocus sequence typing (MLST), the population structure of E. faecium was elucidated and the existence of a distinct high-risk enterococcal clonal complex, designated clonal complex-17 (CC17), which is associated with the majority of hospital outbreaks and clinical infections in five continents, was revealed. This complex is correlated with ampicillin and quinolone resistance and with the presence of a putative pathogenicity island. Preliminary MLST data suggest that similar hospital-adapted complexes might also exist in E. faecalis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Ampicillin Resistance / genetics
  • Anti-Bacterial Agents / pharmacology*
  • Biological Evolution
  • Cross Infection / epidemiology*
  • Cross Infection / microbiology*
  • Disease Outbreaks*
  • Drug Resistance / genetics
  • Drug Resistance, Bacterial*
  • Enterococcus faecium / classification
  • Enterococcus faecium / drug effects*
  • Enterococcus faecium / genetics
  • Enterococcus faecium / pathogenicity
  • Europe / epidemiology
  • Genes, Bacterial / genetics
  • Genomic Islands
  • Gram-Positive Bacterial Infections / epidemiology*
  • Gram-Positive Bacterial Infections / microbiology*
  • Humans
  • Molecular Epidemiology
  • Quinolones / pharmacology
  • United States / epidemiology
  • Virulence / genetics


  • Anti-Bacterial Agents
  • Quinolones