{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:25:15Z","timestamp":1777922715015,"version":"3.51.4"},"reference-count":39,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2015,6,1]],"date-time":"2015-06-01T00:00:00Z","timestamp":1433116800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:p>\n                    In 2009 during surveillance in a Brazilian hospital, many patients were confirmed to be colonized by vancomycin-resistant enterococci (VRE) and a few infection cases occurred. Among 14 isolates of\n                    <jats:italic toggle=\"yes\">Enterococcus faecalis<\/jats:italic>\n                    , most had the same pulsotype, virulence profile (\n                    <jats:italic toggle=\"yes\">\n                      agg\n                      <jats:sup>+<\/jats:sup>\n                      elr\n                    <\/jats:italic>\n                    A\n                    <jats:sup>\n                      <jats:italic toggle=\"yes\">+<\/jats:italic>\n                    <\/jats:sup>\n                    <jats:italic toggle=\"yes\">gel<\/jats:italic>\n                    E\n                    <jats:sup>\n                      <jats:italic toggle=\"yes\">+<\/jats:italic>\n                    <\/jats:sup>\n                    ), and were sequence type (ST)103, indicating dissemination of a clone. The 47\n                    <jats:italic toggle=\"yes\">Enterococcus faecium<\/jats:italic>\n                    were separated into four pulsotypes, the predominant virulence profile being\n                    <jats:italic toggle=\"yes\">\n                      esp\n                      <jats:sup>+<\/jats:sup>\n                      acm\n                      <jats:sup>+<\/jats:sup>\n                    <\/jats:italic>\n                    . All of them harbored the hospital marker IS\n                    <jats:italic toggle=\"yes\">16<\/jats:italic>\n                    , and three randomly chosen isolates were ST412, belonging to the Clonal Complex 17.\n                    <jats:italic toggle=\"yes\">E. faecalis<\/jats:italic>\n                    were all susceptible to penicillin and ampicillin, while all\n                    <jats:italic toggle=\"yes\">E. faecium<\/jats:italic>\n                    were resistant to them. All isolates were susceptible to daptomycin and tigecycline. There were no\n                    <jats:italic toggle=\"yes\">rep<\/jats:italic>\n                    -family genes common to all VRE. The VanA element of all\n                    <jats:italic toggle=\"yes\">E. faecium<\/jats:italic>\n                    lost its left-side inverted repeat (IR\n                    <jats:sub>L<\/jats:sub>\n                    ) region and had a specific IS insertion. On the other hand, all\n                    <jats:italic toggle=\"yes\">E. faecalis<\/jats:italic>\n                    presented intact Tn\n                    <jats:italic toggle=\"yes\">1546<\/jats:italic>\n                    . The size of plasmids containing the\n                    <jats:italic toggle=\"yes\">van<\/jats:italic>\n                    A gene as well as its\n                    <jats:italic toggle=\"yes\">rep<\/jats:italic>\n                    -families varied between and within species. The lack of a\n                    <jats:italic toggle=\"yes\">van<\/jats:italic>\n                    A plasmid common to all VRE, together with the differences among VanA elements, despite the fact that some patients were colonized by both species during their hospitalization, leads us to suggest at least two different Tn\n                    <jats:italic toggle=\"yes\">1546<\/jats:italic>\n                    origins.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2014.0077","type":"journal-article","created":{"date-parts":[[2015,1,14]],"date-time":"2015-01-14T12:43:54Z","timestamp":1421239434000},"page":"320-328","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["Different VanA Elements in\n                    <i>E. faecalis<\/i>\n                    and in\n                    <i>E. faecium<\/i>\n                    Suggest at Least Two Origins of Tn\n                    <i>1546<\/i>\n                    Among VRE in a Brazilian Hospital"],"prefix":"10.1177","volume":"21","author":[{"given":"Tha\u00eds Panhan","family":"Merlo","sequence":"first","affiliation":[{"name":"Universidade de S\u00e3o Paulo","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrei Nicoli Gebieluca","family":"Dabul","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilana Lopes Baratella Cunha","family":"Camargo","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2015,6]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro2761"},{"key":"e_1_3_3_3_2","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1128\/jb.175.1.117-127.1993","article-title":"Characterization of Tn1546, a Tn3-related transposon conferring glycopeptide resistance by synthesis of depsipeptide peptidoglycan precursors in Enterococcus faecium BM4147","volume":"75","author":"Arthur M.","year":"1993","unstructured":"Arthur M., , Molinas C., , Depardieu F., , and Courvalin P. 1993. Characterization of Tn1546, a Tn3-related transposon conferring glycopeptide resistance by synthesis of depsipeptide peptidoglycan precursors in Enterococcus faecium BM4147. J. Bacteriol., 75:117\u2013127.","journal-title":"J. Bacteriol."},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.00279-07"},{"key":"e_1_3_3_5_2","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1139\/w04-054","article-title":"Identification of an unusual VanA element in glycopeptide-resistant Enterococcus faecium in Brazil following international transfer of a bone marrow transplant patient","volume":"50","author":"Camargo I.L.","year":"2004","unstructured":"Camargo I.L., , Del Peloso P.F., , Da Costa Leite C.F., , Goldman G.H., , and Darini A.L. 2004. Identification of an unusual VanA element in glycopeptide-resistant Enterococcus faecium in Brazil following international transfer of a bone marrow transplant patient. Can. J. Microbiol., 50:767\u2013770.","journal-title":"Can. J. Microbiol."},{"key":"e_1_3_3_6_2","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1111\/j.1469-0691.2006.01496.x","article-title":"Multilocus sequence typing and analysis of putative virulence factors in vancomycin-resistant and vancomycin-sensitive Enterococcus faecium isolates from Brazil","volume":"12","author":"Camargo I.L.","year":"2006","unstructured":"Camargo I.L., , Gilmore M.S., , and Darini A.L. 2006. Multilocus sequence typing and analysis of putative virulence factors in vancomycin-resistant and vancomycin-sensitive Enterococcus faecium isolates from Brazil. Clin. Microbiol. Infect., 12:1123\u20131130.","journal-title":"Clin. Microbiol. Infect."},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.13.4.686"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0015798"},{"key":"e_1_3_3_9_2","unstructured":"Clinical and Laboratory Standards Institute (CLSI). 2013. 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