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Applied and Environmental Microbiology, September 2005, p. 5383-5390, Vol. 71, No. 9
0099-2240/05/$08.00+0     doi:10.1128/AEM.71.9.5383-5390.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Occurrence and Relatedness of Vancomycin-Resistant Enterococci in Animals, Humans, and the Environment in Different European Regions

Inger Kühn,1* Aina Iversen,1 Maria Finn,2 Christina Greko,2 Lars G. Burman,3 Anicet R. Blanch,4 Xavier Vilanova,4 Albert Manero,4 Huw Taylor,5 Jonathan Caplin,5 Lucas Domínguez,6 Inmaculada A. Herrero,6 Miguel A. Moreno,6 and Roland Möllby1

Microbiology and Tumor Biology Center, Karolinska Institutet, SE-171 77 Stockholm, Sweden,1 National Veterinary Institute (SVA), Department of Antibiotics, SE-750 07 Uppsala, Sweden,2 Swedish Institute for Infectious Disease Control, SE-171 82 Solna, Sweden,3 Department of Microbiology, University of Barcelona, Diagonal 645, 08028 Barcelona, Spain,4 Environment & Public Health Research Unit, School of the Environment, University of Brighton, Lewes Road, Brighton BN2 4GJ, United Kingdom,5 Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense, 28040 Madrid, Spain6

Received 19 October 2004/ Accepted 23 March 2005

Vancomycin-resistant enterococcci (VRE) in Europe are thought to have emerged partly due to the use of the glycopeptide avoparcin in animal husbandry. We compared the occurrence of VRE in geographical regions of Europe in which until 1997 large amounts of avoparcin were used (Spain, United Kingdom, and Denmark) with the occurrence of VRE in Sweden, where avoparcin was banned in 1986. We also studied the relatedness between VRE strains from different regions and habitats. In total, 2,580 samples were collected from humans, animals, and the environment (soil, sewage, recipient water). VRE resistant to 20 µg/ml vancomycin were identified in 8.2% of the samples and were found most frequently in raw and treated urban sewage samples (means, 71% and 36% of the samples, respectively), pig manure (17%), and hospital sewage (16%). The proportions of VRE-positive sewage samples were similar in Sweden, Spain, and the United Kingdom, whereas pig feces and manure were more often positive in Spain than in Sweden (30% versus 1%). Most VRE were Enterococcus faecium carrying vanA, and computerized biochemical phenotyping of the isolates of different ecological origins showed a high degree of polyclonality. In conclusion, it seems that animal-associated VRE probably reflect the former use of avoparcin in animal production, whereas VRE in human-associated samples may be a result of antibiotic use in hospitals. Since there seems to be a reservoir of the resistance genes in all countries studied, precautions must be taken to limit the use of antibiotics and antibiotic-like feed additives.


* Corresponding author. Mailing address: Microbiology and Tumor Biology Center, Karolinska Institutet, Box 280, SE-171 77 Stockholm, Sweden. Phone: 46 8 5248 71 55. Fax: 46 8 5248 79 08. E-mail: inger.kuhn{at}mtc.ki.se.


Applied and Environmental Microbiology, September 2005, p. 5383-5390, Vol. 71, No. 9
0099-2240/05/$08.00+0     doi:10.1128/AEM.71.9.5383-5390.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.




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