@entity6375 is both a commensal of the @entity1 intestinal tract and an opportunistic pathogen. The increasing incidence of @entity281 is mainly due to the ability of this organism to develop resistance to multiple antibiotics, including @entity2176 . The aim of this study was to perform comparative genome analyses on four @entity2176 -resistant @entity6375 (VREfm) strains isolated from two fatal cases in a tertiary hospital in Malaysia. Two sequence types, ST80 and ST203, were identified which belong to the clinically important clonal complex (CC) 17. This is the first report on the emergence of ST80 strains in Malaysia. Three of the studied strains (VREr5, VREr6, VREr7) were each isolated from different body sites of a single @entity1 ( @entity1 Y) and had different @entity20297 patterns. While VREr6 and VREr7 were phenotypically and genotypically similar, the initial isolate, VREr5, was found to be more similar to VRE2 isolated from another @entity1 ( @entity1 X), in terms of the genome contents, sequence types and phylogenomic relationship. Both the clinical records and genome sequence data suggested that @entity1 Y was infected by multiple strains from different clones and the strain that infected @entity1 Y could have derived from the same clone from @entity1 X. These multidrug resistant strains harbored a number of virulence genes such as the epa locus and pilus-associated genes which could enhance their persistence. Apart from that, a homolog of @entity797 @entity5157 locus was identified in VREr5 which might be involved in biofilm formation. Overall, our comparative genomic analyses had provided insight into the genetic relatedness, as well as the virulence potential, of the four clinical strains.

Comparative genome analysis of multiple XXXX -resistant @entity6375 isolated from two fatal cases.

@entity1 :: ('9606', 'Species') :: ['human', 'patient'] @entity2176 :: ('MESH:D014640', 'Chemical') :: ['vancomycin'] @entity20297 :: ('25870', 'Gene') :: ['PFGE'] @entity281 :: ('MESH:D007239', 'Disease') :: ['enterococcal infections'] @entity797 :: ('1351', 'Species') :: ['E. faecalis'] @entity6375 :: ('1352', 'Species') :: ['Enterococcus faecium'] @entity5157 :: ('7460', 'Species') :: ['bee']
@entity2176 :: (MESH:D014640,Chemical) :: ['vancomycin']
