Research Article
A Genomic Snapshot of Antibiotic-ResistantEnterococcus
faecalis within Public Hospital Environments in South Africa
Christiana O. Shobo,
1,2,3
Daniel G. Amoako ,
1,3
Mushal Allam ,
4,5
Arshad Ismail ,
5,6
Sabiha Y. Essack ,
1
and Linda A. Bester
3,6
1
Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu•Natal, Durban 4000, South Africa
2
School of Laboratory Medicine and Medical Science, Department of Medical Microbiology, University of KwaZulu•Natal,
Durban 4000, South Africa
3
Biomedical Resource Unit, School of Laboratory Medicine and Medical Sciences, College of Health Sciences,
University of KwaZulu•Natal, Durban 4000, South Africa
4
Department of Genetics and Genomics, College of Medicine and Health Sciences, United Arab mirates University,
Al Ain 15551, UA
5
Sequencing Core Facility, National Institute for Communicable Diseases, National Health Laboratory Service,
Johannesburg 2131, South Africa
6
Department of Biochemistry and Microbiology, Faculty of Science, ngineering and Agriculture, University of Venda,
Tohoyandou 0950, South Africa
Corresponence shoul be aresse to Daniel G. Amoako; amoakog@gmail.com an Lina A. Bester; besterl@ukzn.ac.za
Received 17 January 2023; Revised 31 May 2023; Accepted 5 June 2023; Published 12 June 2023
Acaemic Eitor: Omar Enzo Santangelo
Copyright © 2023 Christiana O. Shobo et al. Tis is an open access article istribute uner the Creative Commons Attribution
License, which permits unrestricte use, istribution, an reprouction in any meium, provie the original work is properly
cite.
Enterococci are among the most common opportunistic hospital pathogens. Tis stuy use whole•genome sequencing (WGS) an
bioinformatics to etermine the antibiotic resistome, mobile genetic elements, clone an phylogenetic relationship of nterococcus
faecalis isolate from hospital environments in South Africa. Tis stuy was carrie out from September to November 2017. Isolates
were recovere from 11 frequently touche sites by patients an healthcare workers in iferent wars at 4 levels of healthcare (A, B, C,
an D) in Durban, South Africa. Out of the 245 ientife .faecalis isolates, 38 isolates unerwent whole•genome sequencing (WGS)
on the Illumina MiSeq platform, following microbial ientifcation an antibiotic susceptibility tests. Te tet(M) (31/38, 82%) an
erm(C) (16/38, 42%) genes were the most common antibiotic•resistant genes foun in isolates originating from iferent hospital
environments which corroborate with their antibiotic resistance phenotypes. Te isolates harboure mobile genetic elements
consisting of plasmis (n = 11) an prophages (n = 14) that were mostly clone•specifc. Of note, a large number of insertion sequence
(IS) families were foun on the IS3 (55%), IS5 (42%), IS1595 (40%), an Tn3 transposons the most preominant. Microbial typing
using WGS ata reveale 15 clones with 6 major sequence types (ST) belonging to ST16 (n = 7), ST40 (n = 6), ST21 (n =5), ST126
(n = 3), ST23 (n = 3), an ST386 (n = 3). Phylogenomic analysis showe that the major clones were mostly conserve within specifc
hospital environments. However, further metaata insights reveale the complex intraclonal sprea of these . faecalis major clones
between the sampling sites within each specifc hospital setting. Te results of these genomic analyses will ofer insights into antibiotic•
resistant. faecalis in hospital environments relevant to the esign of optimal infection prevention strategies in hospital settings.
1. Introduction
Te surveillance of hospital environments can be a useful tool
to better unerstan the opportunistic microbial communi•
ties within the hospital (Comar et al., 2019), to ientify the
source of an outbreak [1], an to evaluate the efcacy of
environmental isinfection or other infection prevention an
control measures [2]. Inaequate control practices have
playe a signifcant role in the issemination, persistence, an
intra an interhospital sprea of rug•resistant organisms.
Hindawi
Global Health, Epidemiology and Genomics
Volume 2023, Article ID 6639983, 11 pages
https://doi.org/10.1155/2023/6639983