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Title: Increasing tolerance of hospital Enterococcus faecium to handwash alcohols.
Austin Authors: Pidot, Sacha J;Gao, Wei;Buultjens, Andrew H;Monk, Ian R;Guerillot, Romain;Carter, Glen P;Lee, Jean Y H;Lam, Margaret M C;Grayson, M Lindsay ;Ballard, Susan A;Mahony, Andrew A ;Grabsch, Elizabeth A ;Kotsanas, Despina;Korman, Tony M;Coombs, Geoffrey W;Robinson, J Owen;Gonçalves da Silva, Anders;Seemann, Torsten;Howden, Benjamin P ;Johnson, Paul D R ;Stinear, Timothy P
Affiliation: Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Victoria 3010, Australia
Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Department of Epidemiology and Preventive Medicine, Monash University, Victoria 3800, Australia
Monash Infectious Diseases, Monash Health, Clayton, Victoria 3168, Australia
Antimicrobial Resistance and Infectious Diseases Research Laboratory, School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia, Australia
Department of Microbiology, PathWest Laboratory Medicine WA, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Victoria, Australia
Melbourne Bioinformatics, University of Melbourne, Carlton, Victoria, Australia
Issue Date: 1-Aug-2018
Publication information: Science translational medicine 2018; 10(452): eaar6115
Abstract: Alcohol-based disinfectants and particularly hand rubs are a key way to control hospital infections worldwide. Such disinfectants restrict transmission of pathogens, such as multidrug-resistant Staphylococcus aureus and Enterococcus faecium Despite this success, health care infections caused by E. faecium are increasing. We tested alcohol tolerance of 139 hospital isolates of E. faecium obtained between 1997 and 2015 and found that E. faecium isolates after 2010 were 10-fold more tolerant to killing by alcohol than were older isolates. Using a mouse gut colonization model of E. faecium transmission, we showed that alcohol-tolerant E. faecium resisted standard 70% isopropanol surface disinfection, resulting in greater mouse gut colonization compared to alcohol-sensitive E. faecium We next looked for bacterial genomic signatures of adaptation. Alcohol-tolerant E. faecium accumulated mutations in genes involved in carbohydrate uptake and metabolism. Mutagenesis confirmed the roles of these genes in the tolerance of E. faecium to isopropanol. These findings suggest that bacterial adaptation is complicating infection control recommendations, necessitating additional procedures to prevent E. faecium from spreading in hospital settings.
DOI: 10.1126/scitranslmed.aar6115
ORCID: 0000-0003-1202-6614
PubMed URL: 30068573
Type: Journal Article
Appears in Collections:Journal articles

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