Epidemiological linkage of vancomycin-resistant Enterococcus faecium from different sources in Ahwaz, Iran

Abstract

This study was set to determine the genetic linkage and the clonal relationship between vancomycin-resistant Enterococcusfaecium (VREfm) isolates in three hospitals of Ahwaz city. In this study, 1050 samples were collected from various rectal swabs, hands of health care workers, environmental surfaces, medical equipment and 146 enterococci isolates from clinical sources of three hospitals from March to September 2015. Antimicrobial resistance patterns in VREfm were detected by disk diffusion method. Genetic linkages of VREfm strains were investigated by pulse field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) methods. Out of 366 enterococcal isolates, 163 Enterococcus faecium isolates were found to be resistant to vancomycin. PFGE and MLST analysis showed the presence of 79 pulsotypes and 11 sequence types (ST), respectively. In total, 90% of the isolates belonged to clonal complex 17 (CC17). Three new STs were reported for the first time in this study and ST80 was the predominant ST. We found a high prevalence of diverse VREfm with threatening antibiotic resistance patterns in all the studied sources with the dominance of CC17 VREfm strains in Ahwaz hospitals. Also, the results of typing method showed inter- and intra-hospital circulation of VREfm and similar pulsotypes and STs among different sources.

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

“…In the current study, 84% of the isolates were resistant to ampicillin. This resistance rate was in agreement with the reports published by Jia et al [11], Arshadi et al [23], and Boccella et al [29] in China, Iran, and Italy, respectively, but higher than those reported by Karna et al [26] in India and Asadollahi et al [31] in Iran. The frequency of resistance to tetracycline, minocycline, and teicoplanin was 78.4%, 78.4%, and 56.8%, which was relatively similar to those reported by Asadollahi et al [31] and Arabestani et al [33] in Iran, but higher than those reported by Jia et al [11] in China, Boccella et al [29] in Italy, and Karna et al [26] inIndia and lower than the results obtained by other researchers from Egypt, India, and Iran [23,26,30].…”

“…In our study, we found a high prevalence of resistance to ciprofloxacin and levofloxacin in E. faecium isolates. This resistance rate was in agreement with the reports published by Arshadi et al [23], Sattari-Maraji et al [24], and Jia et al [22], in Iran and China, but higher than those reported by Kateete et al [25], Karna et al [26], Tian et al [27], and Arbabi et al [28] in Uganda, India, China, and Iran, respectively. Extensive or irrational use of these antibiotics to treat a wide range of bacterial infections may explain the higher resistance to this antibiotic compared to other antimicrobials.…”

Complete genome sequence and characterization of a novel Enterococcus faecium with probiotic potential isolated from the gut of Litopenaeus vannamei

“…On the other hand, some studies report that most E. faecium strains isolated from intra-hospital infection cases carry three virulence factors: enterococcal surface protein ( esp ), hyaluronidase ( hyl ) and collagen-binding adhesin ( acm ) [83]. From these, only the gene acm was identified in our isolate.…”

“…The simple presence of some players may be due to their contribution to the enterococci commensal lifestyle and their noninfectious interaction with the host [ 82 ]. On the other hand, some studies report that most E. faecium strains isolated from intra-hospital infection cases carry three virulence factors: enterococcal surface protein ( esp ), hyaluronidase ( hyl ) and collagen-binding adhesin ( acm ) [ 83 ]. From these, only the gene acm was identified in our isolate.…”

The Interconnection between Virulence Factors, Biofilm Formation, and Horizontal Gene Transfer in Enterococcus: A Review

“…They commonly cause infections of the urinary tract and wounds in hospitals, as well as endocarditis or bacteremia [5]. Most human enterococcal infections are caused by Enterococcus faecalis, accounting for 80-90% of cases, and E. faecium for most of the remaining cases.…”