Ecological replacement of Enterococcus faecalis by multiresistant clonal complex 17 Enterococcus faecium

Clin Microbiol Infect. 2007 Mar;13(3):316-9. doi: 10.1111/j.1469-0691.2006.01631.x.


The proportion of enterococcal infections caused by ampicillin-resistant Enterococcus faecium (AREfm) in a European hospital increased from 2% in 1994 to 32% in 2005, with prevalence rates of AREfm endemicity of up to 35% in at least six hospital wards. Diabetes mellitus, three or more admissions in the preceding year, and use of beta-lactams and fluoroquinolones, were all associated with AREfm colonisation. Of 217 AREfm isolates that were genotyped, 97% belonged to clonal complex 17 (CC17). This ecological change mimics events preceding the emergence of vancomycin-resistant E. faecium (VREF) in the USA and may presage the emergence of CC17 VREF in European hospitals.

MeSH terms

  • Ampicillin Resistance
  • Drug Resistance, Multiple, Bacterial
  • Ecology
  • Enterococcus faecalis / drug effects*
  • Enterococcus faecalis / genetics
  • Enterococcus faecium / drug effects*
  • Enterococcus faecium / genetics
  • Gram-Positive Bacterial Infections / epidemiology*
  • Humans
  • Minisatellite Repeats
  • Vancomycin Resistance