Increasing tolerance of hospital Enterococcus faecium to handwash alcohols

Sacha J. Pidot, Wei Gao, Andrew H. Buultjens, Ian R. Monk, Romain Guerillot, Glen P. Carter, Jean Y.H. Lee, Margaret M.C. Lam, M. Lindsay Grayson, Susan A. Ballard, Andrew A. Mahony, Elizabeth A. Grabsch, Despina Kotsanas, Tony M. Korman, Geoffrey W. Coombs, J. Owen Robinson, Anders Gonçalves Da Silva, Torsten Seemann, Benjamin P. Howden, Paul D.R. Johnson & 1 others Timothy P. Stinear

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Alcohol-based disinfectants and particularly hand rubs are a key way to control hospital infections worldwide. Such disinfectants restrict transmission of pathogens, such as multidrug-resistant Staphylococcus aureus and Enterococcus faecium. Despite this success, health care infections caused by E. faecium are increasing. We tested alcohol tolerance of 139 hospital isolates of E. faecium obtained between 1997 and 2015 and found that E. faecium isolates after 2010 were 10-fold more tolerant to killing by alcohol than were older isolates. Using a mouse gut colonization model of E. faecium transmission, we showed that alcohol-tolerant E. faecium resisted standard 70% isopropanol surface disinfection, resulting in greater mouse gut colonization compared to alcohol-sensitive E. faecium. We next looked for bacterial genomic signatures of adaptation. Alcohol-tolerant E. faecium accumulated mutations in genes involved in carbohydrate uptake and metabolism. Mutagenesis confirmed the roles of these genes in the tolerance of E. faecium to isopropanol. These findings suggest that bacterial adaptation is complicating infection control recommendations, necessitating additional procedures to prevent E. faecium from spreading in hospital settings.

Original languageEnglish
Article numbereaar6115
Number of pages11
JournalScience Translational Medicine
Volume10
Issue number452
DOIs
Publication statusPublished - 1 Aug 2018

Cite this

Pidot, S. J., Gao, W., Buultjens, A. H., Monk, I. R., Guerillot, R., Carter, G. P., ... Stinear, T. P. (2018). Increasing tolerance of hospital Enterococcus faecium to handwash alcohols. Science Translational Medicine, 10(452), [eaar6115]. https://doi.org/10.1126/scitranslmed.aar6115
Pidot, Sacha J. ; Gao, Wei ; Buultjens, Andrew H. ; Monk, Ian R. ; Guerillot, Romain ; Carter, Glen P. ; Lee, Jean Y.H. ; Lam, Margaret M.C. ; Grayson, M. Lindsay ; Ballard, Susan A. ; Mahony, Andrew A. ; Grabsch, Elizabeth A. ; Kotsanas, Despina ; Korman, Tony M. ; Coombs, Geoffrey W. ; Robinson, J. Owen ; Da Silva, Anders Gonçalves ; Seemann, Torsten ; Howden, Benjamin P. ; Johnson, Paul D.R. ; Stinear, Timothy P. / Increasing tolerance of hospital Enterococcus faecium to handwash alcohols. In: Science Translational Medicine. 2018 ; Vol. 10, No. 452.
@article{02064e0f22824452902db151051eeb5f,
title = "Increasing tolerance of hospital Enterococcus faecium to handwash alcohols",
abstract = "Alcohol-based disinfectants and particularly hand rubs are a key way to control hospital infections worldwide. Such disinfectants restrict transmission of pathogens, such as multidrug-resistant Staphylococcus aureus and Enterococcus faecium. Despite this success, health care infections caused by E. faecium are increasing. We tested alcohol tolerance of 139 hospital isolates of E. faecium obtained between 1997 and 2015 and found that E. faecium isolates after 2010 were 10-fold more tolerant to killing by alcohol than were older isolates. Using a mouse gut colonization model of E. faecium transmission, we showed that alcohol-tolerant E. faecium resisted standard 70{\%} isopropanol surface disinfection, resulting in greater mouse gut colonization compared to alcohol-sensitive E. faecium. We next looked for bacterial genomic signatures of adaptation. Alcohol-tolerant E. faecium accumulated mutations in genes involved in carbohydrate uptake and metabolism. Mutagenesis confirmed the roles of these genes in the tolerance of E. faecium to isopropanol. These findings suggest that bacterial adaptation is complicating infection control recommendations, necessitating additional procedures to prevent E. faecium from spreading in hospital settings.",
author = "Pidot, {Sacha J.} and Wei Gao and Buultjens, {Andrew H.} and Monk, {Ian R.} and Romain Guerillot and Carter, {Glen P.} and Lee, {Jean Y.H.} and Lam, {Margaret M.C.} and Grayson, {M. Lindsay} and Ballard, {Susan A.} and Mahony, {Andrew A.} and Grabsch, {Elizabeth A.} and Despina Kotsanas and Korman, {Tony M.} and Coombs, {Geoffrey W.} and Robinson, {J. Owen} and {Da Silva}, {Anders Gon{\cc}alves} and Torsten Seemann and Howden, {Benjamin P.} and Johnson, {Paul D.R.} and Stinear, {Timothy P.}",
year = "2018",
month = "8",
day = "1",
doi = "10.1126/scitranslmed.aar6115",
language = "English",
volume = "10",
journal = "Science Translational Medicine",
issn = "1946-6234",
publisher = "American Association for the Advancement of Science",
number = "452",

}

Pidot, SJ, Gao, W, Buultjens, AH, Monk, IR, Guerillot, R, Carter, GP, Lee, JYH, Lam, MMC, Grayson, ML, Ballard, SA, Mahony, AA, Grabsch, EA, Kotsanas, D, Korman, TM, Coombs, GW, Robinson, JO, Da Silva, AG, Seemann, T, Howden, BP, Johnson, PDR & Stinear, TP 2018, 'Increasing tolerance of hospital Enterococcus faecium to handwash alcohols', Science Translational Medicine, vol. 10, no. 452, eaar6115. https://doi.org/10.1126/scitranslmed.aar6115

Increasing tolerance of hospital Enterococcus faecium to handwash alcohols. / Pidot, Sacha J.; Gao, Wei; Buultjens, Andrew H.; Monk, Ian R.; Guerillot, Romain; Carter, Glen P.; Lee, Jean Y.H.; Lam, Margaret M.C.; Grayson, M. Lindsay; Ballard, Susan A.; Mahony, Andrew A.; Grabsch, Elizabeth A.; Kotsanas, Despina; Korman, Tony M.; Coombs, Geoffrey W.; Robinson, J. Owen; Da Silva, Anders Gonçalves; Seemann, Torsten; Howden, Benjamin P.; Johnson, Paul D.R.; Stinear, Timothy P.

In: Science Translational Medicine, Vol. 10, No. 452, eaar6115, 01.08.2018.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Increasing tolerance of hospital Enterococcus faecium to handwash alcohols

AU - Pidot, Sacha J.

AU - Gao, Wei

AU - Buultjens, Andrew H.

AU - Monk, Ian R.

AU - Guerillot, Romain

AU - Carter, Glen P.

AU - Lee, Jean Y.H.

AU - Lam, Margaret M.C.

AU - Grayson, M. Lindsay

AU - Ballard, Susan A.

AU - Mahony, Andrew A.

AU - Grabsch, Elizabeth A.

AU - Kotsanas, Despina

AU - Korman, Tony M.

AU - Coombs, Geoffrey W.

AU - Robinson, J. Owen

AU - Da Silva, Anders Gonçalves

AU - Seemann, Torsten

AU - Howden, Benjamin P.

AU - Johnson, Paul D.R.

AU - Stinear, Timothy P.

PY - 2018/8/1

Y1 - 2018/8/1

N2 - Alcohol-based disinfectants and particularly hand rubs are a key way to control hospital infections worldwide. Such disinfectants restrict transmission of pathogens, such as multidrug-resistant Staphylococcus aureus and Enterococcus faecium. Despite this success, health care infections caused by E. faecium are increasing. We tested alcohol tolerance of 139 hospital isolates of E. faecium obtained between 1997 and 2015 and found that E. faecium isolates after 2010 were 10-fold more tolerant to killing by alcohol than were older isolates. Using a mouse gut colonization model of E. faecium transmission, we showed that alcohol-tolerant E. faecium resisted standard 70% isopropanol surface disinfection, resulting in greater mouse gut colonization compared to alcohol-sensitive E. faecium. We next looked for bacterial genomic signatures of adaptation. Alcohol-tolerant E. faecium accumulated mutations in genes involved in carbohydrate uptake and metabolism. Mutagenesis confirmed the roles of these genes in the tolerance of E. faecium to isopropanol. These findings suggest that bacterial adaptation is complicating infection control recommendations, necessitating additional procedures to prevent E. faecium from spreading in hospital settings.

AB - Alcohol-based disinfectants and particularly hand rubs are a key way to control hospital infections worldwide. Such disinfectants restrict transmission of pathogens, such as multidrug-resistant Staphylococcus aureus and Enterococcus faecium. Despite this success, health care infections caused by E. faecium are increasing. We tested alcohol tolerance of 139 hospital isolates of E. faecium obtained between 1997 and 2015 and found that E. faecium isolates after 2010 were 10-fold more tolerant to killing by alcohol than were older isolates. Using a mouse gut colonization model of E. faecium transmission, we showed that alcohol-tolerant E. faecium resisted standard 70% isopropanol surface disinfection, resulting in greater mouse gut colonization compared to alcohol-sensitive E. faecium. We next looked for bacterial genomic signatures of adaptation. Alcohol-tolerant E. faecium accumulated mutations in genes involved in carbohydrate uptake and metabolism. Mutagenesis confirmed the roles of these genes in the tolerance of E. faecium to isopropanol. These findings suggest that bacterial adaptation is complicating infection control recommendations, necessitating additional procedures to prevent E. faecium from spreading in hospital settings.

UR - http://www.scopus.com/inward/record.url?scp=85050966350&partnerID=8YFLogxK

U2 - 10.1126/scitranslmed.aar6115

DO - 10.1126/scitranslmed.aar6115

M3 - Article

VL - 10

JO - Science Translational Medicine

JF - Science Translational Medicine

SN - 1946-6234

IS - 452

M1 - eaar6115

ER -

Pidot SJ, Gao W, Buultjens AH, Monk IR, Guerillot R, Carter GP et al. Increasing tolerance of hospital Enterococcus faecium to handwash alcohols. Science Translational Medicine. 2018 Aug 1;10(452). eaar6115. https://doi.org/10.1126/scitranslmed.aar6115