Correlation between Infective Factors and Antibiotic Resistance inEnterococciClinical Isolates in West of Iran

Abstract

The present study was done to scrutinize the possible relation between infective genes and antimicrobial resistance in Enterococcus faecalis and Enterococcus faecium. Considering the fact that the presence of recognized infective determinants among clinical isolates may promote the emergence of infections and persistence of Enterococci in hospital settings, which can lead to an increase in antimicrobial resistance. 175 E. faecalis and 67 E. faecium isolated from clinical specimens were used. The isolates were identified, and then antibiotic susceptibility testing was performed. The MIC of vancomycin and teicoplanin were determined by broth microdilution method. The presence of infective genes esp, hyl and asa1 was scrutinized using PCR. Of the 280 enterococcal isolates, 175 (62.5%) isolates were identified as E. faecalis, 67 (24%) as E. faecium and 38 (13.5%) as Enterococcus spp. The results of the antibiotic susceptibility testing showed resistance rates of 5% and 73% to vancomycin and teicoplanin in E. faecalis and E. faecium isolates, respectively. The statistical analysis showed that the esp infective gene has significant associations with ciprofloxacin, erythromycin and tetracycline in E. faecium and with chloramphenicol in E. faecalis strains; the hyl with teicoplanin and vancomycin in E. faecium strains; and also asa1 with vancomycin in E. faecium and with ampicillin and chloramphenicol in E. faecalis strains. Regarding the relationships between virulence genes and antibiotic resistance in strains of E. faecalis and E. faecium, detection of infective factors associated with invasive diseases has become a major issue of concern.

Prevalence, Antimicrobial Susceptibility Patterns, and Risk Factors Associated with Enterococci among Pediatric Patients at Dessie Referral Hospital, Northeastern Ethiopia

“…The rate of 5/11 (45.5%) vancomycin-resistant enterococci (VRE) in the current study has made the scenario worse as it is the preferred choice of drug in the case where this bacterium became resistant to other antibiotics in the area. Even though the result was comparable with the study report undertaken in all age groups in Gondar, 41.5% [16], and Nigeria, 42.9% [35], while it was by far greater than reports of other studies conducted among HIV patients in Ethiopia: Gondar, 5.5% [12], southern Ethiopia, 7.5% [15], Addis Ababa, 6.7% [23], Jimma, 22.7% [11], 6.3% [14], west Iran, 24% [36], Canada, 4% [33], and reports of a nationwide study from Europe, Asia and Pacific, Latin and North America, 1% to 9.8% [10]. The possible reason might be due to the gradual change in the MDR strains, antibiotics selective pressure, differences in drug prescription and usage habits, and socioeconomic status.…”

“…In this study, higher antimicrobial resistance was seen against commonly used antibiotics including tetracycline (91%), amoxicillin/clavulanic acid (72.7%), chloramphenicol (83%), and erythromycin (66.7%). This finding was higher than reports from southern Ethiopia [34], Jimma [14], Gondar [16], and India [32,36]. This was the most striking finding of this study which is alarming indicator of heightened prevalence of multidrug resistance.…”

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

“…During the initial database search, a total of 150 articles were found. After exclusion of the articles according to our criteria, a total of 44 articles were included in the analysis [3] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] . Among these 44 articles, 24 were associated with general patients (3071 isolates), 12 studies assessed their enterococcal populations on the basis of species (3906 isolates) and eight investigated colonization of enterococci among complicated patients with specific underlying conditions (589 isolates).…”

Vancomycin-Resistant Enterococci: A Review of Antimicrobial Resistance Mechanisms and Perspectives of Human and Animal Health

“…209 These genes, are part of a putative pathogenicity island and considered to be a marker for nosocomial-epidemicity that contributes to the acquisition of antimicrobial resistant genes and spread of vancomycinresistant E. faecium isolates in hospitals. 210 Thus, the administration of glycopeptides for humans and previous use as feed additive growth promoters in animals are important factors in the emergence of vancomycin resistance in enterococci, 103,147 but other virulence factors appear necessary before these subpopulations are represented in human clinical infections. 211 Since year 2000, VRE rates in human clinical isolates have increased in numerous European countries despite glycopeptide resistance declining in nonhospital reservoirs.…”