Distribution of Multidrug Efflux Pump Genes in Enterococci spp. Isolated from Bovine Milk Samples and Their Antibiotic Resistance Patterns

Kang, SoWon; Lee, Sang-Jin; Choi, SungSook

doi:10.7845/kjm.2013.3025

Cited by 4 publications

(6 citation statements)

References 23 publications

(17 reference statements)

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“…Several studies have shown various multidrug efflux pumps in E. faecium, such as efmA, emeA, and efrAB, which are involved in resistance to fluoroquinolones. In this study, the frequency of emeA was 54.5%, which is in agreement with the report published by Jia et al [11] in China, but higher than Kang et al [6] and Sobhanipoor et al [37] in Korea and Iran, respectively. Also, the frequency of efrA/efrB was 51%, which is higher than those reported by Kang et al [6], Sobhanipoor et al [37], and Valenzuela et al [38] in Korea, Iran, and Spain, respectively and lower than the report published by Jabbari et al [39] in Iran.…”

Section: Discussionsupporting

confidence: 93%

“…Various mechanisms are involved in the development of resistant strains [3]. Several studies have shown that efflux pumps have become a serious concern for the treatment of infections with multidrug-resistant E. faecium strains [3][4][5][6]. Efflux pumps can not only repel a wide range of antibiotics due to their poly-substance properties but also achieve greater resistance mechanisms by reducing the concentration of intracellular antibiotics and increasing the accumulation of mutations [7].…”

Section: Introductionmentioning

confidence: 99%

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Antibiotic resistance assessment and multi-drug efflux pumps of Enterococcus faecium isolated from clinical specimens

Mirzaii

Alebouyeh

Sohrabi

et al. 2023

J Infect Dev Ctries

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Introduction: Enterococcus faecium is a major cause of community and hospital-acquired infections. Due to limited options for infection with fluoroquinolones-resistant Enterococci, novel therapeutics are urgently needed. Efflux pumps are contributed to fluoroquinolones resistance phenotype in this bacterium and novel inhibitors that target these efflux pumps could be effective in patients. In this research, the possible synergistic effect of an efflux pump inhibitor (EPI), thioridazine, with ciprofloxacin was investigated against clinical isolates of E. faecium. Methodology: A total of 88 isolates of E. faecium from clinical specimens were studied from August 2017 to September 2018. Conventional phenotypic and molecular methods characterized all the isolates. Standard susceptibility tests and molecular assays determined the antibiotic resistance profiles and the frequency of efflux pump genes. Minimum inhibitory concentrations (MICs) to ciprofloxacin (CIP) in the presence and absence of thioridazine were measured by the micro-broth dilution method. Results: The highest antibiotic resistance rate among E. faecium isolates was related to ciprofloxacin (96.8%), levofloxacin (94.3%), and imipenem (90.9%), respectively. The highest frequency of efflux pump determinants was related to efmA (60, 68%), followed by emeA (48, 54.5%), and efrA and/or efrB genes (45, 51%). The efflux pump inhibitor showed ≥ 2-fold decrease in the MIC value of ciprofloxacin in 48.2% of the isolates. Conclusions: Efflux pump inhibitor genes efrAB, efmA, and emeA are common among the E. faecium clinical isolates. Our results supported the administration of thioridazine, as an efflux pump inhibitor, in fluoroquinolone-resistant E. faecium infections due to its synergistic effect with CIP.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Antibiotic resistance assessment and multi-drug efflux pumps of Enterococcus faecium isolated from clinical specimens

Mirzaii

Alebouyeh

Sohrabi

et al. 2023

J Infect Dev Ctries

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“…We also surveyed the existence of efrA and efrB genes in extracted DNA by PCR. The results were higher than in the results of Valenzuela et al's [12] and Kang et al's [32] studies. With the aim to explain that involvement of efrAB in CIP resistance, we investigated that effect of CCCP as an efflux inhibitor on decrease of CIP MIC.…”

Section: Discussioncontrasting

confidence: 68%

First detection of efrAB, an ABC multidrug efflux pump in Enterococcus faecalis in Tehran, Iran

Shiadeh

Hashemi

Fallah

et al. 2018

AMicr

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Enterococcus faecalis is one of the most significant pathogen in both nosocomial and community-acquired infections. Reduced susceptibility to antibiotics is in part due to efflux pumps. This study was conducted on 80 isolates of E. faecalis isolated from outpatients with urinary tract infection during a period of 1 year from April 2014 to April 2015. The antibiotic susceptibility patterns of isolates were determined by the disk diffusion method and presence of efrA and efrB genes was detected by PCR and sequencing. Minimum inhibitory concentrations (MICs) to ciprofloxacin (CIP) were measured with and without carbonyl cyanide 3-chlorophenylhydrazone (CCCP) by broth microdilution. The highest resistance rate was observed to erythromycin (83.3%) and the prevalence of efrA and efrB genes in all E. faecalis isolates was 100%. This study showed that 9 out of 13 (69.2%) ciprofloxacin-resistant isolates became less resistant at least fourfolds to CIP in the presence of efflux pump inhibitor. Our result showed that CCCP as an efflux inhibitor can increase effect of CIP as an efficient antibiotic and it is suggested that efrAB efflux pumps are involved in resistance to fluoroquinolone.

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“…Additionally, another study found the overexpression in efrAB efflux pump, work as an MDR transporter in Escherichia coli [4]. The other studies has been investigated in fermented or dairy foods [30,43,44]. Our study found one ST847 and two ST480 in E. faecalis isolates.…”

Section: Discussionsupporting

confidence: 56%

Upregulation of efrAB efflux pump among Enterococcus faecalis ST480, ST847 in Iran

Shiadeh

Azimi

et al. 2020

AMicr

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Antibiotic resistance and especially multiresistance in Enterococci, is a serious public health issue especially in infections of immunocompromised patients. EfrAB is a heterodimeric multidrug ATP-binding cassette (ABC) transporter that causes endogenous resistance to antimicrobials including fluoroquinolones in Enterococcus spp. The aim of this study was to seek the gene expression rate and role of efrAB efflux pump in ciprofloxacin resistant Enterococcus faecalis and Multilocus Sequence Typing (MLST) of multiresistant isolates. Phenotypic and genotyping identification of 80 E. faecalis isolates were performed. Minimum inhibitory concentrations (MICs) to ciprofloxacin (CIP) were measured with and without carbonylcyanide 3-chlorophenylhydrazone (CCCP) by broth microdilution. After DNA extraction and sequencing for detection of efrA and efrB genes, the efrAB efflux positive isolates that were resistant to ciprofloxacin and showed decrease of ciprofloxacin MIC range were identified. Isolates that exhibited decrease in ciprofloxacin MIC range from two to ten folds were assessed for biofilm formation and finally, the expression levels of efrB, efrA genes were measured by quantitative Real-Time PCR (qRT-PCR). High rates of resistance to tetracycline and minocycline and low rates of resistance to the most antibiotics used in this study were detected. The results in this study indicated that the incidence of Multiple drug resistance (MDR) was 23.7% and all isolates that were resistant to ciprofloxacin revealed several degrees of overexpression in efrA and efrB genes. Our study found two ST480 and one ST847 in E. faecalis isolates. In conclusion, despite of low frequency of resistance to the most antibiotics and MDRs in our region, we found one ST480 isolate with resistance to eight antibiotics that also exists in other parts of the world.

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Distribution of Multidrug Efflux Pump Genes in Enterococci spp. Isolated from Bovine Milk Samples and Their Antibiotic Resistance Patterns

Cited by 4 publications

References 23 publications

Antibiotic resistance assessment and multi-drug efflux pumps of Enterococcus faecium isolated from clinical specimens

Antibiotic resistance assessment and multi-drug efflux pumps of Enterococcus faecium isolated from clinical specimens

First detection of efrAB, an ABC multidrug efflux pump in Enterococcus faecalis in Tehran, Iran

Upregulation of efrAB efflux pump among Enterococcus faecalis ST480, ST847 in Iran

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