faecium strains, while the second pair F1 (5′-GCAAGGCTTCTTAGAGA-3

faecium strains, while the second pair F1 (5′-GCAAGGCTTCTTAGAGA-3′)/F2 (5′-CATCGTGTAAGCTAACTTC-3′) is specific for Enterococcus faecalis. Identification of the rest of isolates was performed by sequencing the 470 pb fragment of the 16S rDNA gene PCR amplified using the primers pbl16 (5′-AGAGTTTGATCCTGGCTCAG-3′) and mbl16 (5′-GGCTGCTGGCACGTAGTTAG-3′) [31]. The PCR conditions were as follows: 96°C for 30 s, 48°C

for 30 s and 72°C for 45 s (40 cycles) and a final extension at 72°C for 4 min. The amplicons were purified using the Nucleospin® Extract II kit (Macherey-Nagel, Düren, Germany) and sequenced at the Genomics Unit of the Universidad Complutense de Madrid, Spain. The resulting sequences were used to search sequences deposited in the EMBL database using BLAST algorithm Akt inhibitor and the identity of the isolates was determined on the basis of the highest scores (>99%). Genetic profiling of the enterococcal isolates Initially, the enterococcal isolates were typed by Random Amplification of Polymorphic DNA (RAPD) in order to avoid duplication of isolates from a same host. RAPD profiles were obtained GW2580 clinical trial using primer OPL5 (5′-ACGCAGGCAC-3′), as described by Ruíz-Barba et al. [32]. Later, a representative of each RAPD profile found in each host was submitted to PFGE genotyping [33]; for this purpose, chromosomal DNA was digested

with the endonuclease SmaI (New England Biolabs, Ipswich, MA) at 37°C for 16 h. Then, electrophoresis was carried out in a CHEF DR-III apparatus (Bio-Rad) for 23 h at 14°C at 6 V/cm with pulses from 5 to 50 s. A standard pattern (Lamda Ladder PFG Marker, New England Biolabs) was included in the gels to compare the digitally normalized PFGE profiles. Computer-assisted analysis was performed with the Phoretix 1D Pro software (Nonlinear

USA, Inc., Durham, NC). Multilocus sequence typing (MLST) Molecular typing of E. faecalis and E. faecium isolates was performed by MLST. Internal fragments of seven housekeeping genes of E. faecalis (gdh, gyd, pstS, gki, aroE, xpt and yiqL) and E. faecium (atpA, ddl, gdh, purK, gyd, pstS, and adk) were amplified and sequenced. The sequences obtained were analyzed and compared with those included in the website database (http://​efaecalis.​mlst.​net/​), and a specific Miconazole sequence type (ST) and clonal MGCD0103 chemical structure complex (CC) was assigned [34, 35]. Screening for virulence determinants, hemolysis and gelatinase activity A multiplex PCR method [15] was used to detect the presence of virulence determinants encoding sex pheromones (ccf, cpd, cad, cob), adhesins (efa Afs , efa Afm ), and products involved in aggregation (agg2), biosynthesis of an extracellular metalloendopeptidase (gelE), biosynthesis of cytolysin (cylA) and immune evasion (esp fs). The primers couples used to detect all the genes cited above were those proposed by Eaton and Gasson [22].

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