Whole-genome characterization of clinical Enterococcus faecalis and Staphylococcus epidermidis Isolates reveals mecA-positive E. faecalis and a shared lnu(A)-rep7a resistance plasmid in Türkiye

Abstract

Background: This study aimed to genomically characterize clinical Enterococcus faecalis and Staphylococcus epidermidis isolates obtained from aspirate and sputum samples at Bayburt State Hospital, focusing on antimicrobial resistance genes, virulence factors, and mobile genetic elements.

Methods: Whole-genome sequencing (WGS) was performed on the isolates, and antimicrobial resistance genes, virulence determinants, multilocus sequence types (MLST), plasmid replicons, and mobile genetic elements were identified using bioinformatics tools.

Results: The E. faecalis E5 (ST64) isolate, recovered from an aspirate sample, carried multiple antimicrobial resistance genes, including mecA, vanT, erm(B), tet(M), and qacA, along with a diverse virulence gene repertoire (cyl, ebp, ace, and agg), mobile genetic elements (Tn6009, ISL1a3), and four plasmid replicons (rep19C, rep9C, repUS43, and rep7a). The E. faecalis E184 and E187 isolates (ST124), obtained from sputum samples, harbored fewer acquired resistance genes but shared gyrA (T672A) and parC (V307I) mutations associated with fluoroquinolone resistance. The S. epidermidis ST59 isolate carried resistance genes lnu(A), fosB, and qacD, together with the plasmid replicon rep7a and insertion sequence ISSau4. The co-occurrence of lnu(A) and the rep7a plasmid in both species suggests a potential pathway for interspecies transmission of resistance determinants.

Conclusions: This study reports the genomic detection of mecA in an E. faecalis isolate from Türkiye based on WGS analysis. However, this finding is based solely on genomic data and lacks phenotypic or experimental validation. The detection of a shared plasmid-associated resistance element (lnu(A)-rep7a) in both E. faecalis and S. epidermidis highlights the potential for interspecies resistance gene flow within the hospital environment.