High prevalence of diverse vancomycin resistance Enterococcus faecium isolates in clinical and environmental sources in ICU wards in southwest of Iran

Arshadi, Maniya; Douraghi, Masoumeh; Shokoohizadeh, Leili; Moosavian, Mojtaba; Pourmand, Mohammad Reza

doi:10.1016/j.micpath.2017.08.045

Cited by 10 publications

(6 citation statements)

References 42 publications

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“…Most of the enterococcal isolates (54.4%) were collected from urine, followed by blood (35%), and wound (10.7%). Previous reports have also indicated that UTI is the most common infection caused by enterococci, followed by surgical site infections (SSI), bacteremia, and endocarditis 42–44…”

Section: Discussionmentioning

confidence: 99%

<p>Emergence of multidrug resistance and extensive drug resistance among enterococcal clinical isolates in Egypt</p>

Said¹,

Abdelmegeed²

2019

IDR

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Introduction Enterococci commonly inhabit the gastrointestinal tract of both human and animals; however, they have emerged as a leading cause of several infections with substantial morbidity and mortality. Their ability to acquire resistance combined with intrinsic resistance to various antimicrobials makes treatment of enterococcal infections challenging. Materials and methods The aim of the study was to evaluate the antimicrobial resistance pattern, and assess the prevalence of multidrug resistance (MDR) and extensive drug resistance (XDR) among enterococcal isolates, collected from different clinical sources, in Mansoura University Hospitals, Egypt. Results Antibiotic sensitivity testing revealed elevated levels of resistance among enterococcal clinical isolates (N=103). All E. faecium (N=32) and 74.6% of E. faecalis isolates (N=71) were MDR, while two E. faecalis and four E. faecium isolates were XDR. High level gentamicin resistance was detected in 79.6%, most of them carried the aac(6’)-Ie-aph(2’’)-Ia gene. High level streptomycin resistance was seen in 36.9%, of which 52.6% carried the ant(6’)-Ia gene. Resistance to macrolides and lincosamides were mediated by ermB (92.2%) and msrA/B (42.7%). tetK , tetL , and tetM genes were detected among tetracyclines resistant isolates. Resistance to vancomycin was detected in 15.5%, where vanB and vanC 1 gene clusters were detected in VRE isolates. Ten isolates (9.7%) were resistant to linezolid, eight of which harbored the optrA gene. Vancomycin and linezolid resistant enterococci were more likely to exhibit strong/moderate biofilm formation than vancomycin and linezolid sensitive ones. Conclusion Elevated levels of resistance to different classes of antimicrobial agents and emergence of MDR and XDR strains pose a major threat with limited therapeutic options for infections caused by this emerging pathogen.

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Section: Discussionmentioning

confidence: 99%

<p>Emergence of multidrug resistance and extensive drug resistance among enterococcal clinical isolates in Egypt</p>

Said¹,

Abdelmegeed²

2019

IDR

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“…Among Gram-positive and Gram-negative bacteria, Staphylococcus aureus and Pseudomonas aeruginosa are considered as the most important factors causing burn wound infections [ 5 ]. According to reports published in recent years, enterococci have become important factors in acquiring nosocomial infections [ 6 – 8 ]. These Gram-positive bacteria are part of the normal flora of the human digestive system and were considered to be commensal bacteria in the past [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Antimicrobial resistance patterns and virulence factors of enterococci isolates in hospitalized burn patients

et al. 2018

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ObjectiveThe objective of this study was to determine the frequency of the antimicrobial resistance and genes encoding virulence factors of enterococci isolated in hospitalized burn patients in a major burn center in Ahvaz, southwest of Iran. A total of 340 bacterial isolates were collected from the burn center from February 2014 to February 2015. The antimicrobial susceptibility and MIC of vancomycin were determined using the disk diffusion and micro-agar dilution techniques. The genus and species-specific genes, potential virulence genes, and vanA and vanB genes were detected by polymerase chain reaction.ResultsAccording to our results, out of the 340 bacterial isolates, 16.4% (n = 56) were identified as enterococci. Out of the 56 enterococcal isolates, 35 (62.5%) were Enterococcus faecalis and 21 (37.5%) were Enterococcus faecium. More than 20% (n = 5) of E. faecium demonstrated resistance to vancomycin. The gelE and asa genes were the most prevalent virulence genes in E. faecalis (48.5%) and E. faecium (43%) isolates. The emergence of vancomycin resistant E. faecium strains which have several virulence factors should be considered as a major cause of concern for burn centers. Control and management of infections induced by enterococci should be regarded as highly important in burn patients.

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“…Currently enterococci, Gram-positive bacteria that are component of the usual fora of the human gut, were considered as the third recorded cause of nosocomial infections 1 . Since enterococci can acquire antibiotic resistance genes, they become naturally resistant to many antibiotics and can cause infection in wounds, including burn wounds 2 .…”

Section: Introductionmentioning

confidence: 99%

Linezolid Susceptibility and Virulence Factors in Vancomycin Resistant Enterococcus faecalis and Enterococcus faecium among Hospitalized Burn Patients

Elaskary

Zaher

2022

Egyptian Journal of Medical Microbiology

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Background: Enterococci are the 3rd cause of HAIs. E. faecalis and E. faecium are the commonest enterococcal species, showed resistance to vancomycin due to resistance genes (vanA, vanB and vanC). Linezolid is considered a good substitute. The virulence factors like asa1, gelE, cylA, esp, and hyl may interfere with antibiotic susceptibility. Objectives: Determine linezolid resistance in VR E. faecalis and E. faecium in relation to virulence factors. Methodology: Enterococcus spp. identified by colony morphology, Gram stain, biochemical reactions and by the VITEK 2 system. Antibiotic susceptibility was done through VITEK 2 system, AST-GP72 card. Vancomycin and linezolid MIC were done according to CLSI. Multiplex PCR for ddl E. faecalis , ddl E. faecium . vanA and vanB detection. Other for asa1, gelE, cylA, esp, and hyl virulence genes determination then conventional PCR for cfr and optrA genes were done. Results: A total of 65 enterococci CIs. (45 E. faecalis & 20 E. faecium) were isolated from different samples. E. faecalis and E. faecium were resistant to vancomycin by 11,1% and 35% and to linezolid by 4.4% and 10% respectively. The vanA, vanB, cfr and optrA genes were present in 100% of VR E. faecalis like E. faecium except that, the cfr was not detected. The gelE was frequently detected in E. faecalis followed by asa1, esp, hyl and finally cylA. And for E. faecium, the most frequent one was asa1followed by gelE. esp, and finally cylA and hyl. Conclusions: LZD resistant enterococci were increasingly detected, with no significant relation between linezolid resistance and vancomycin resistance. And with different impact of virulence genes.

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High prevalence of diverse vancomycin resistance Enterococcus faecium isolates in clinical and environmental sources in ICU wards in southwest of Iran

Cited by 10 publications

References 42 publications

<p>Emergence of multidrug resistance and extensive drug resistance among enterococcal clinical isolates in Egypt</p>

<p>Emergence of multidrug resistance and extensive drug resistance among enterococcal clinical isolates in Egypt</p>

Antimicrobial resistance patterns and virulence factors of enterococci isolates in hospitalized burn patients

Linezolid Susceptibility and Virulence Factors in Vancomycin Resistant Enterococcus faecalis and Enterococcus faecium among Hospitalized Burn Patients

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