Jpn. J. Infect. Dis., 54 (1), 17-22, 2001

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Original Article

Molecular and Epidemiological Study of the First Outbreak of vanB Type Vancomycin-Resistant Enterococcus faecalis in Japan

Kozue Oana*, Yoshiyuki Kawakami, Makoto Ohnishi¹, Masayo Ishikawa², Masako Hirota², Minoru Tozuka², Kenichi Atarashi³, Kousuke Baba³, Kyoko Fujiki³, Mitsuo Okazaki⁴, Takayuki Honda⁵ and Tetsuya Hayashi¹

Department of Medical Technology, School of Allied Medical Sciences, Shinshu University, ²Central Clinical Laboratories, Shinshu University Hospital and ⁵Department of Laboratory Medicine, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto 390-8621, ¹Department of Microbiology, Miyazaki Medical College, Kiyotake 5200, Miyazaki 889-1692, ³Department of Infection Control Committee, Hokushin General Hospital, Nishi 1-5-63, Nakano 383-0021 and ⁴Gene Research Center and Department of Applied Biology, Faculty of Textile Science and Technology, Shinshu University, Tokita 3-15-1, Ueda 386-8567, Japan

(Received October 24, 2000. Accepted March 1, 2001)

SUMMARY: In July, 1999, an outbreak of vancomycin-resistant Enterococcus faecalis (VREF) with the vanB genotype occurred for the first time in Japan at Hokushin General Hospital, Nakano City, Nagano Prefecture. Four VREF strains were isolated from the clinical specimens of four inpatients, and 16 VREF strains were isolated by the screening of asymptomatic carriers and by surveillance of the hospital environment. All of the isolates possessed vanB genes. In a pulsed-field gel electrophoresis analysis, 19 out of 20 VREF isolates exhibited the indistinguishable restriction endonuclease digestion patterns of the chromosomal DNA. Additional investigation by Southern hybridization using the vanB probe implied that the vanB gene of these 19 isolates was encoded on a 110-kb plasmid. These findings indicate that the outbreak was principally caused by a single clone. The restriction endonuclease digestion patterns of the remaining single isolate was different from those of the other isolates. The vanB gene was encoded on the chromosome.

Corresponding author: Tel: +81-263-37-2387, Fax: +81-263-37-2370,
E-mail: koana@gipac.shinshu-u.ac.jp

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