Volume 9, Number 9, September 2003

Epidemic and Nonepidemic Multidrug-Resistant Enterococcus faecium

Helen L. Leavis,*† Rob J.L. Willems,† Janetta Top,† Emile Spalburg,† Ellen M. Mascini,* Ad C. Fluit,* Andy Hoepelman,* Albert J. de Neeling,† and Marc J.M. Bonten*
*University Medical Center Utrecht, Utrecht, the Netherlands; and †National Institute of Public Health and the Environment (RIVM), Bilthoven, the Netherlands

Figure 3. Hypothetical evolutionary scheme for Enterococcus faecium genotypes and phenotypes from an ancestral E. faecium type. Open slices indicate esp-negative, ampicillin-susceptible, and vancomycin-susceptible. Closed slices indicate esp-positive, ampicillin-resistant, and vancomycin-resistant. Numbers indicate the number of strains. Arrows indicate the putative evolutionary direction. Clin-Inf, clinical infectious; Clin-Surv, clinical survey; Comm-Surv, community survey. ^a, dominant genogroup (A,C) for vancomycin-resistant enterococci and dominant cluster (2,3,4) for vancomycin-susceptible enterococci. ^b, clinical relevant strains (“yes”) are the total of epidemic and clinical infectious isolates, clinical nonrelevant strains (“no”) are the total of clinical and community survey isolates.

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This page last reviewed July 30, 2003

Emerging Infectious Diseases Journal
National Center for Infectious Diseases
Centers for Disease Control and Prevention