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Genetic diversity and persistent colonization of <Emphasis Type="Italic">Enterococcus faecalis</Emphasis> on ocular surfaces
Authors:Daisuke Todokoro  Hiroshi Eguchi  Takashi Suzuki  Motoo Suzuki  Haruyuki Nakayama-Imaohji  Tomomi Kuwahara  Takahiro Nomura  Haruyoshi Tomita  Hideo Akiyama
Institution:1.Department of Ophthalmology,Gunma University Graduate School of Medicine,Maebashi,Japan;2.Department of Ophthalmology,Kindai University,Osaka,Japan;3.Department of Ophthalmology, School of Medicine,Toho University,Tokyo,Japan;4.Department of Molecular Microbiology, Faculty of Medicine,Kagawa University,Kita-gun,Japan;5.Department of Bacteriology,Gunma University Graduate School of Medicine,Maebashi,Japan;6.Laboratory of Bacterial Drug Resistance,Gunma University Graduate School of Medicine,Maebashi,Japan
Abstract:

Purpose

Enterococcus faecalis causes severe acute endophthalmitis and often leads to poor visual outcomes. Conjunctival bacterial cultures occasionally grow atypical bacteria including E. faecalis, which can potentially contribute to the development of postoperative endophthalmitis. However, the characteristics of these ocular E. faecalis strains are unknown. This study is the first attempt to determine the population characteristics of E. faecalis clinical isolates from eye infections and ocular commensals.

Study design

Retrospective

Methods

Twenty-eight E. faecalis ocular isolates were collected from 23 patients at 3 referring hospitals. The multilocus sequence typing (MLST) data were analyzed using the eBURST program. Phenotypes of cytolysin and gelatinase, antibiotic susceptibility, and mutations of the quinolone resistance-determining regions (QRDRs) of gyrA and parC were also examined. Pulsed-field gel electrophoresis (PFGE) was performed for strains from the same patients.

Results

PFGE revealed that 3 patients retained identical strains for 10 months to 2 and a half years. MLST identified 12 sequence types (STs), which were clustered into 3 clonal complexes (CCs) and 8 singletons, with ST179 the largest. Thirteen of the 23 isolates (56.5%) belonged to CC58, CC8, or CC2, which have previously been reported to be major CCs. Six of the 23 strains (26.0%) exhibited high-level quinolone resistance derived from mutations of the QRDRs in both gyrA and parC.

Conclusions

The sequence types of E. faecalis ocular isolates were divergent, with no eye-specific lineages observed. Persistent colonization of E. faecalis on the ocular surface was demonstrated in patients with chronic ocular surface diseases.
Keywords:
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