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Journal of Bacteriology, February 2004, p. 672-682, Vol. 186, No. 3
0021-9193/04/$08.00+0     DOI: 10.1128/JB.186.3.672-682.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

A Novel Putative Enterococcal Pathogenicity Island Linked to the esp Virulence Gene of Enterococcus faecium and Associated with Epidemicity

Helen Leavis,1,2 Janetta Top,1 Nathan Shankar,3 Katrine Borgen,1 Marc Bonten,2 Jan van Embden,4 and Rob J. L. Willems1,5*

Diagnostic Laboratory for Infectious Diseases and Perinatal Screening,1 and Laboratory for Vaccine Preventable Diseases,4 National Institute for Public Health and the Environment, Bilthoven, and Department of Internal Medicine, Division of Acute Internal Medicine and Infectious Diseases,2 and Eijkman-Winkler Institute for Microbiology, Infectious Diseases and Inflammation,5 University Medical Center Utrecht, Utrecht, The Netherlands, and Department of Pharmaceutical Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 731903

Received 2 July 2003/ Accepted 29 October 2003

Enterococcus faecalis harbors a virulence-associated surface protein encoded by the esp gene. This gene has been shown to be part of a 150-kb putative pathogenicity island. A gene similar to esp has recently been found in Enterococcus faecium isolates recovered from hospitalized patients. In the present study we analyzed the polymorphism in the esp gene of E. faecium, and we investigated the association of esp with neighboring chromosomal genes. The esp gene showed considerable sequence heterogeneity in the regions encoding the nonrepeat N- and C-terminal domains of the Esp protein as well as differences in the number of repeats. DNA sequencing of chromosomal regions flanking the esp gene of E. faecium revealed seven open reading frames, representing putative genes implicated in virulence, regulation of transcription, and antibiotic resistance. These flanking regions were invariably associated with the presence or absence of the esp gene in E. faecium, indicating that esp in E. faecium is part of a distinct genetic element. Because of the presence of virulence genes in this gene cluster, the lower G+C content relative to that of the genome, and the presence of esp in E. faecium isolates associated with nosocomial outbreaks and clinically documented infections, we conclude that this genetic element constitutes a putative pathogenicity island, the first one described in E. faecium. Except for the presence of esp and araC, this pathogenicity island is completely different from the esp-containing pathogenicity island previously disclosed in E. faecalis.

* Corresponding author. Mailing address: Eijkman-Winkler Institute for Microbiology, Infectious Diseases and Inflammation, University Medical Center Utrecht, Heidelberglaan 100, Rm G04.614, 3584CX Utrecht, The Netherlands. Phone: 31-30-2507637. Fax: 31-30-2541770. E-mail: r.willems{at}azu.nl.

Journal of Bacteriology, February 2004, p. 672-682, Vol. 186, No. 3
0021-9193/04/$08.00+0     DOI: 10.1128/JB.186.3.672-682.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



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