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Background  Enterococci rank among the leading causes of nosocomial infections. The failure to identify pathogen-specific genes in  Enterococcus faecalis  has led to a hypothesis where the virulence of different strains may be linked to strain-specific genes, and where the combined endeavor of the different gene-sets result in the ability to cause infection. Population structure studies by multilocus sequence typing have defined distinct clonal complexes (CC) of  E. faecalis  enriched in hospitalized patients (CC2, CC9, CC28 and CC40).    Results  In the present study, we have used a comparative genomic approach to investigate gene content in 63  E. faecalis  strains, with a special focus on CC2. Statistical analysis using Fisher's exact test revealed 252 significantly enriched genes among CC2-strains. The majority of these genes were located within the previously defined mobile elements  phage03  (n = 51),  efaB5  (n = 34) and a  vanB  associated genomic island (n = 55). Moreover, a CC2-enriched genomic islet (EF3217 to -27), encoding a putative phage related element within the V583 genome, was identified. From the draft genomes of CC2-strains HH22 and TX0104, we also identified a CC2-enriched non-V583 locus associated with the  E. faecalis  pathogenicity island (PAI). Interestingly, surface related structures (including MSCRAMMs, internalin-like and WxL protein-coding genes) implicated in virulence were significantly overrepresented (9.1%;  p  = 0.036, Fisher's exact test) among the CC2-enriched genes.    Conclusion  In conclusion, we have identified a set of genes with potential roles in adaptation or persistence in the hospital environment, and that might contribute to the ability of CC2  E. faecalis  isolates to cause disease.

bmc microbiology

Comparative genomic analysis reveals significant enrichment of mobile genetic elements and genes encoding surface structure-proteins in hospital-associated clonal complex 2 Enterococcus faecalis