Vancomycin Resistance in Enterococcus faecium from the Dallas, Texas, Area Is Conferred Predominantly on pRUM-Like Plasmids

Islam, Moutusee; Sharon, Belle M.; Abaragu, Ada; Sistu, Harita; Akins, Ronda L.; Palmer, Kelli L.

doi:10.1128/msphere.00024-23

Cited by 2 publications

(1 citation statement)

References 45 publications

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“…So, in severe infections, glyco- and lipopeptides such as vancomycin and daptomycin, or oxazolidinones such as linezolid are among the few remaining therapeutic options ( 25 , 26 ). But even to these compounds, enterococci have developed resistance mechanisms encoded on mobile genetic elements or plasmids ( 27 , 28 ). So far, this type of vancomycin resistance encoded by the vanA or vanB genes has predominantly been demonstrated in Enterococcus faecium but may also be present in Enterococcus faecalis ( 29 – 33 ).…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of vancomycin-resistant enterococci in the United Arab Emirates: a retrospective analysis of 12 years of national AMR surveillance data

Thomsen,

Abdulrazzak,

AlRand

et al. 2023

Front. Public Health

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IntroductionEnterococci are usually low pathogenic, but can cause invasive disease under certain circumstances, including urinary tract infections, bacteremia, endocarditis, and meningitis, and are associated with peritonitis and intra-abdominal abscesses. Increasing resistance of enterococci to glycopeptides and fluoroquinolones, and high-level resistance to aminoglycosides is a concern. National antimicrobial resistance (AMR) surveillance data for enterococci from the Middle East and North Africa (MENA) and the Gulf region is scarce.MethodsA retrospective 12-year analysis of N = 37,909 non-duplicate diagnostic Enterococcus spp. isolates from the United Arab Emirates (UAE) was conducted. Data was generated by routine patient care during 2010–2021, collected by trained personnel and reported by participating surveillance sites to the UAE National AMR Surveillance program. Data analysis was conducted with WHONET.ResultsEnterococcus faecalis was the most commonly reported species (81.5%), followed by Enterococcus faecium (8.5%), and other enterococci species (4.8%). Phenotypically vancomycin-resistant enterococci (VRE) were found in 1.8% of Enterococcus spp. isolates. Prevalence of VRE (%VRE) was highest for E. faecium (8.1%), followed by E. faecalis (0.9%). A significant level of resistance to glycopeptides (%VRE) for these two species has been observed in the majority of observed years [E. faecalis (0–2.2%), 2010: 0%, 2021: 0.6%] and E. faecium (0–14.2%, 2010: 0%, 2021: 5.8%). Resistance to fluoroquinolones was between 17 and 29% (E. faecalis) and was higher for E. faecium (between 42 and 83%). VRE were associated with higher patient mortality (RR: 2.97), admission to intensive care units (RR: 2.25), and increased length of stay (six excess inpatient days per VRE case), as compared to vancomycin-susceptible Enterococcus spp.DiscussionPublished data on Enterococcus infections, in particular VRE-infections, in the UAE and MENA region is scarce. Our data demonstrates that VRE-enterococci are relatively rare in the UAE, however showing an increasing resistance trend for several clinically important antibiotic classes, causing a concern for the treatment of serious infections caused by enterococci. This study also demonstrates that VRE were associated with higher mortality, increased intensive care unit admission rates, and longer hospitalization, thus poorer clinical outcome and higher associated costs in the UAE. We recommend the expansion of current surveillance techniques (e.g., local VRE screening), stricter infection prevention and control strategies, and better stewardship interventions. Further studies on the molecular epidemiology of enterococci are needed.

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Section: Introductionmentioning

confidence: 99%

Epidemiology of vancomycin-resistant enterococci in the United Arab Emirates: a retrospective analysis of 12 years of national AMR surveillance data

Thomsen,

Abdulrazzak,

AlRand

et al. 2023

Front. Public Health

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Healthcare-associated vanA-positive Enterococcus faecium clone ST612 emerging as pathogen of companion animals in Brazil

Sacramento,

Sartori,

Fontana

et al. 2024

Journal of Antimicrobial Chemotherapy

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Vancomycin Resistance in Enterococcus faecium from the Dallas, Texas, Area Is Conferred Predominantly on pRUM-Like Plasmids

Abstract: Vancomycin is an antibiotic used to treat infections caused by multidrug-resistant Gram-positive bacteria. Vancomycin resistance is common in clinical isolates of the Gram-positive pathogen Enterococcus faecium .

Cited by 2 publications

References 45 publications

Epidemiology of vancomycin-resistant enterococci in the United Arab Emirates: a retrospective analysis of 12 years of national AMR surveillance data

Epidemiology of vancomycin-resistant enterococci in the United Arab Emirates: a retrospective analysis of 12 years of national AMR surveillance data

Healthcare-associated vanA-positive Enterococcus faecium clone ST612 emerging as pathogen of companion animals in Brazil

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