Antimicrobial resistance pattern of Gram-positive bacteria during three consecutive years at the nephrology ward of a tertiary referral hospital in Shiraz, Southwest Iran

Karimzadeh, Iman; Mirzaee, Mona; Sadeghimanesh, Niloofar; Sagheb, Mohammad Mahdi

doi:10.4103/2279-042x.192460

Cited by 10 publications

(4 citation statements)

References 27 publications

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“…Nearly half of the isolates were resistant to vancomycin (45.1%). Similarly, high prevalence of vancomycin-resistant enterococci has been previously reported from southwestern Iran [1317]. All of isolates were susceptible to fosfomycin and linezolid (Table 1).…”

Section: Discussionsupporting

confidence: 69%

High Incidence of Virulence Factors Among ClinicalEnterococcus faecalisIsolates in Southwestern Iran

et al. 2017

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BackgroundOver the past two decades, enterococci have emerged as an important agent responsible for hospital acquired infection. Several virulence factors contribute to the adherence, colonization, evasion of the host immune response, and pathogenicity and severity of the infection. Enterococcus faecalis is the most common and virulent species causing infections in hospitalized patients. The aim of the present study was to examine the prevalence of genes encoding virulence factors and antimicrobial resistance patterns of E. faecalis strains isolated from hospitalized patients in Shiraz, south west of Iran.Materials and MethodsA total of 51 E. faecalis isolates from the urine, blood, pleural fluid, peritoneal fluid, eye discharge, endotracheal tube (ETT) and transjugular intrahepatic portosystemic shunt (TIPS) specimens of patients were identified by phenotypic and genotypic methods. Antimicrobial sensitivity tests and detection of virulence factors were performed using standard methods.ResultsThe efa and asa1 were the most frequently detected gene (100%) among the isolates, followed by esp (94.1%), ace (90.2%), gelE (80.4%), cylA (64.7%), and hyl (51%). More than half of the isolates (52.9%) were high level gentamicin resistant (HLGR). Vancomycin resistance was observed among 23 (45.1%) isolates. The lowest antimicrobial activity was related to erythromycin (3.9%), tetracycline (5.9%) and ciprofloxacin (9.8%). No isolate was found resistant to fosfomycin and linezolid.ConclusionOur data indicated a high incidence of virulence factors among E. faecalis strains isolated from clinical samples. Colonization of drug resistant virulent isolates in hospital environment may lead to life threatening infection in hospitalized patients. Therefore, infection control procedures should be performed.

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Section: Discussionsupporting

confidence: 69%

High Incidence of Virulence Factors Among ClinicalEnterococcus faecalisIsolates in Southwestern Iran

et al. 2017

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“…During 2014, the mean rate of ampicillin resistance from two distinct studies, one in the south of Iran (Bandar Abbas, n = 54) and another in its south-central region (Shiraz, n = 24), was determined as 14% [49] , [50] . Moreover, no significant difference was seen where different methodologies were used.…”

Section: Discussionmentioning

confidence: 99%

Rise of antibiotic resistance in clinical enterococcal isolates during 2001–2016 in Iran: a review

Asadollahi

Razavi

Asadollahi

et al. 2018

New Microbes and New Infections

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IntroductionThe clinical significance of enterococci is mostly related to its antibiotic resistance which contributes to colonization and infection, in particular amongst the hospitalized patients. The present review has examined the literature to provide a comprehensive data on enterococci antibiotic resistance during the last 20 years in Iran.MethodsSearch engines such as Google Scholar and PubMed were used to identify all Persian and English-language articles investigating enterococci in Iran from 1996 to 2017. The search terms were “enterococci”, “enterococcal”, “enterococcus”, “Iran”, “bacterial resistance”, “antibiotic resistance” and “resistance”.ResultsDecrease in the resistance trend against ampicillin, gentamycin and ciprofloxacin was observed over a period of 15 years (2001 to 2016) in Iran. During a 10 years period from 2001 to 2015, the rate of resistance among Enterococcus faecalis species was less than Enterococcus faecium. The resistancerate, however, was considerably increased for both species during this period. The mean resistance rates for vancomycin, gentamicin, ciprofloxacin, erythromycin, nitrofurantoin, chloramphenicol, trimethoprim-sulfametoxazol, imipenem and teicoplanin were higher among complicated cases (patients with underlying debilitating disorders) compared to general cases (hospitalized or outpatients with no specific underlying disorder).ConclusionsE. faecalis and E. faecium showed a rise in the mean resistance against all the antibiotics during a 10-year period from 2010 to 2015. With the exception of penicillin and ampicillin, resistance to all antibiotics was higher amongst complicated cases compared to general patients.

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“…Due to their importance, antibiotic consumption policies should be taken and implemented in the agenda of the infection control committees of hospitals 7. Generally, studies covering the antibiotic profile of Gram-positive bacteria (GPB) applied a disk diffusion of a range of antibiotics according to the standard Clinical and Laboratory Standards Institute (CLSI) patterns for sensitivity 8. Among these antibiotics, we can note penicillin, methicillin, ampicillin, trimethoprim-sulfamethoxazole, rifampin, clindamycin, ciprofloxacin, and gentamicin 9.…”

Section: Introductionmentioning

confidence: 99%

<p>Antibiotic Resistance And Genotyping Of Gram-Positive Bacteria Causing Hospital-Acquired Infection In Patients Referring To Children’s Medical Center</p>

Mamishi¹,

Mohammadian²,

Pourakbari³

et al. 2019

IDR

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IntroductionA serious problem affecting human society is the development of bacterial resistance. The purpose of the current study was to evaluate the antibiotic resistance of Gram-positive bacteria (GPB) and genotyping of common GPB causing hospital-acquired infections (HAIs) in patients who were referred to Children’s Medical Center during a 6-month period by random amplified polymorphic DNA (RAPD) and enterobacterial repetitive intergenic consensus sequence polymerase chain reaction (ERIC-PCR).MethodsDuring the 6-month period, antimicrobial resistance profiles of GPB isolates recovered from patients in Children’s Medical Center were determined using the Kirby–Bauer disk diffusion and MIC. Typing of common GPB was performed and the results were analyzed by gel compare software.ResultsIn this cross-sectional study, 6524 cultures were performed and 138 Ggram-positive bacteria were isolated (2%). Staphylococcus aureus strains showed the highest antibiotic penicillin resistance (96.3%). Twenty-six per cent of the strains were methicillin-resistant S. aureus (MRSA) and no resistance was found against vancomycin. All isolates of Enterococcus faecium were resistant to ciprofloxacin (100%). The resistance to vancomycin was very high (67%) and no resistance was observed to linezolid. The results of genotyping analysis of S. epidermidis strains showed the presence of two clones with a genetic relationship of over 80%. All of the S. aureus strains were in one cluster and half of the E. faecium strains were in a cluster with a genetic predilection of over 80%.ConclusionThis study indicated frequent occurrence of antimicrobial resistance, especially in Enterococcus spp. isolates. Rapid spreads of MRSA and VREF from a clonal origin require implementing careful isolation and infection control measures.

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Antimicrobial resistance pattern of Gram-positive bacteria during three consecutive years at the nephrology ward of a tertiary referral hospital in Shiraz, Southwest Iran

Cited by 10 publications

References 27 publications

High Incidence of Virulence Factors Among ClinicalEnterococcus faecalisIsolates in Southwestern Iran

High Incidence of Virulence Factors Among ClinicalEnterococcus faecalisIsolates in Southwestern Iran

Rise of antibiotic resistance in clinical enterococcal isolates during 2001–2016 in Iran: a review

<p>Antibiotic Resistance And Genotyping Of Gram-Positive Bacteria Causing Hospital-Acquired Infection In Patients Referring To Children’s Medical Center</p>

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