{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:28:39Z","timestamp":1777922919879,"version":"3.51.4"},"reference-count":42,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2019,5,1]],"date-time":"2019-05-01T00:00:00Z","timestamp":1556668800000},"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":[[2019,5]]},"abstract":"<jats:p>\n                    Vancomycin-resistant Enterococci (VRE) are a major public health problem worldwide, since they are commonly implicated in nosocomial infections in various regions in the world. The aim of our study was to investigate genetic features and clonal relationship of VRE in the Military hospital of Tunisia. A total of 10 VRE strains were initially detected and identified by the Viteck II compact\n                    <jats:sup>\u00ae<\/jats:sup>\n                    (BioM\u00e9rieux\n                    <jats:sup>\u00ae<\/jats:sup>\n                    ) automated system, then confirmed by PCR using specific primers. These VRE strains were isolated during the period extended between September 2015 and January 2017 from anal and blood samples from patients hospitalized mainly in the neonatology service and intensive care unit. All these strains were identified as\n                    <jats:italic toggle=\"yes\">Enterococcus faecium<\/jats:italic>\n                    and carried the\n                    <jats:italic toggle=\"yes\">van<\/jats:italic>\n                    A gene. Other acquired resistance genes were also detected by PCR: [\n                    <jats:italic toggle=\"yes\">erm<\/jats:italic>\n                    B (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u20096);\n                    <jats:italic toggle=\"yes\">tet<\/jats:italic>\n                    L (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u20096);\n                    <jats:italic toggle=\"yes\">tet<\/jats:italic>\n                    M (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u20092);\n                    <jats:italic toggle=\"yes\">aac<\/jats:italic>\n                    (6\u2032)-\n                    <jats:italic toggle=\"yes\">Ie-aph<\/jats:italic>\n                    (2\u2032\u2032)-\n                    <jats:italic toggle=\"yes\">Ia<\/jats:italic>\n                    (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200910);\n                    <jats:italic toggle=\"yes\">aph(3\u2032)-III-a<\/jats:italic>\n                    (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u20099);\n                    <jats:italic toggle=\"yes\">ant<\/jats:italic>\n                    (6)-\n                    <jats:italic toggle=\"yes\">Ia<\/jats:italic>\n                    (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u20098)]. The insertion sequence\n                    <jats:italic toggle=\"yes\">IS<\/jats:italic>\n                    16 was detected in all our tested strains.\n                    <jats:italic toggle=\"yes\">Esp<\/jats:italic>\n                    virulence gene was detected in only one strain. The clonal relatedness of VRE strains screened by pulse-field gel electrophoresis and multi-locus sequence typing showed four clones: two related clones A1 (one strain) and A2 (one strain) ascribed to ST80 belonged to CC17, the other remaining two clones, named B (one strain) and C (seven strains), revealed two new sequences types assigned to ST1463 and ST1464 respectively. The emergence of novel clones of VRE in this hospital could be a warning of rapid evolution of these resistant bacteria, which calls for new surveillance strategies, strict hygiene and practices.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2018.0158","type":"journal-article","created":{"date-parts":[[2018,11,7]],"date-time":"2018-11-07T15:43:20Z","timestamp":1541605400000},"page":"469-474","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Vancomycin-Resistant\n                    <i>Enterococcus faecium<\/i>\n                    in Tunisia: Emergence of Novel Clones"],"prefix":"10.1177","volume":"25","author":[{"given":"Raoudha","family":"Dziri","sequence":"first","affiliation":[{"name":"Laboratory of Microorganisms and Active Biomolecules, Faculty of Sciences of Tunis, University of Tunis El Manar, Tunis, Tunisia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feriel","family":"El Kara","sequence":"additional","affiliation":[{"name":"Service of Microbiology, Military Hospital of Tunis HMPIT, Tunis, Tunisia."},{"name":"Department of Microbiology, Faculty of Pharmacy, University of Monastir, Tunisia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farouk","family":"Barguellil","sequence":"additional","affiliation":[{"name":"Service of Microbiology, Military Hospital of Tunis HMPIT, Tunis, Tunisia."},{"name":"Department of Microbiology, Faculty of Pharmacy, University of Monastir, Tunisia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hadda-Imen","family":"Ouzari","sequence":"additional","affiliation":[{"name":"Laboratory of Microorganisms and Active Biomolecules, Faculty of Sciences of Tunis, University of Tunis El Manar, Tunis, Tunisia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed Selim","family":"El Asli","sequence":"additional","affiliation":[{"name":"Service of Microbiology, Military Hospital of Tunis HMPIT, Tunis, Tunisia."},{"name":"Department of Microbiology, Faculty of Pharmacy, University of Monastir, Tunisia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naouel","family":"Klibi","sequence":"additional","affiliation":[{"name":"Laboratory of Microorganisms and Active Biomolecules, Faculty of Sciences of Tunis, University of Tunis El Manar, Tunis, Tunisia."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,5,8]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1186\/s13756-017-0253-5","article-title":"The effect of antibiotic use on prevalence of nosocomial vancomycin-resistant Enterococci-an ecologic study","volume":"6","author":"Remschmidt C.","year":"2017","unstructured":"Remschmidt C., , Behnke M., , Kola A., , Pe\u00f1a Diaz L.A., , Rohde A.M., , Gastmeier P., , and Schwab F.. 2017. 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