{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T19:57:28Z","timestamp":1783367848119,"version":"3.54.6"},"reference-count":51,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2021,7,23]],"date-time":"2021-07-23T00:00:00Z","timestamp":1626998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007137","name":"Helse Nord RHF","doi-asserted-by":"publisher","award":["HNF1362-17"],"award-info":[{"award-number":["HNF1362-17"]}],"id":[{"id":"10.13039\/501100007137","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007465","name":"uit the arctic university of norway","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100007465","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\nBackground<\/jats:title>\nVancomycin-resistant enterococci (VRE) represent several types of transferable vancomycin resistance gene clusters. The vanD<\/jats:italic> type, associated with moderate to high level vancomycin resistance, has only sporadically been described in clinical isolates. The aim of this study was to perform a genetic characterization of the first VanD-type VRE strains detected in Norway.<\/jats:p>\n<\/jats:sec>\n\nMethods<\/jats:title>\nThe VanD-type VRE-strains (n = 6) from two patient cases were examined by antimicrobial susceptibility testing and whole genome sequencing (WGS) to uncover Van-phenotype, strain phylogeny, the vanD<\/jats:italic> gene clusters, and their genetic surroundings. The putative transferability of vanD<\/jats:italic> was examined by circularization PCR and filter mating.<\/jats:p>\n<\/jats:sec>\n\nResults<\/jats:title>\nThe VanD-type Enterococcus faecium<\/jats:italic> (n = 4) and Enterococcus casseliflavus<\/jats:italic> (n = 2) strains recovered from two cases (A and B), expressed moderate to high level vancomycin resistance (MIC 64\u2014>256 mg\/L) and various levels of teicoplanin susceptibility (MIC 2\u2014>256 mg\/L). WGS analyses revealed phylogenetically different E<\/jats:italic>. faecium<\/jats:italic> strains (A1, A2, and A3 of case A and B1 from case B) as well as vanD<\/jats:italic> gene clusters located on different novel genomic islands (GIs). The E<\/jats:italic>. casseliflavus<\/jats:italic> strains (B2 and B3 of case B) were not clonally related, but harbored nearly identical novel GIs. The vanD<\/jats:italic> cluster of case B strains represents a novel vanD<\/jats:italic>-subtype. All the vanD<\/jats:italic>-GIs were integrated at the same chromosomal site and contained genes consistent with a Clostridiales<\/jats:italic> origin. Circular forms of the vanD<\/jats:italic>-GIs were detected in all strains except B1. Transfer of vanD<\/jats:italic> to an E<\/jats:italic>. faecium<\/jats:italic> recipient was unsuccessful.<\/jats:p>\n<\/jats:sec>\n\nConclusions<\/jats:title>\nWe describe the first VanD-type E<\/jats:italic>. casseliflavus<\/jats:italic> strains, a novel vanD<\/jats:italic>-subtype, and three novel vanD<\/jats:italic>-GIs with a genetic content consistent with a Clostridiales<\/jats:italic> order origin. Despite temporal occurrence, case A and B E<\/jats:italic>. faecium<\/jats:italic> strains were phylogenetically diverse and harbored different vanD<\/jats:italic> subtypes and vanD<\/jats:italic>-GIs.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0255187","type":"journal-article","created":{"date-parts":[[2021,7,23]],"date-time":"2021-07-23T17:34:25Z","timestamp":1627061665000},"page":"e0255187","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":13,"title":["Novel genomic islands and a new vanD-subtype in the first sporadic VanD-type vancomycin resistant enterococci in Norway"],"prefix":"10.1371","volume":"16","author":[{"given":"Mushtaq T. 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