Vancomycin-Resistant Enterococcus spp. Isolated from Wastewater and Chicken Feces in the United States

Abstract

Vancomycin-resistant Enterococcus spp. (VRE) were isolated from sewage and chicken feces but not from other animal fecal sources (dog, cow, and pig) or from surface waters tested. VRE from hospital wastewater were resistant to >20 g of vancomycin/ml and possessed the vanA gene. VRE from residential wastewater and chicken feces were resistant to 3 to 5 g of vancomycin/ml and possessed the vanC gene.Vancomycin resistance in Enterococcus species is becoming a major concern in clinical settings as the rate of occurrence of vancomycin-resistant Enterococcus spp. (VRE) implicated in disease increases. For example, by 1999 the incidence of VREmediated nosocomial infections in intensive care units had increased 43% from that of the period of 1994 to 1998 (23). Enterococcus faecalis and E. faecium are reported more frequently as etiological agents of disease than are other enterococci (14, 15), but other species, such as E. avium (25), occasionally cause disease.Several operons that mediate vancomycin resistance in Enterococcus spp. have been identified. Perhaps the most significant from an epidemiological standpoint is vanA-mediated vancomycin resistance, as these genes are carried on transposon Tn1546 (4) and confer inducible high-level resistance to vancomycin and teicoplanin (19). The chromosomally encoded phenotype mediated by the vanC gene is marked by low-level resistance to vancomycin (20) and is an intrinsic characteristic of E. gallinarum (11), E. casseliflavus, and E. flavescens (24).VRE that are resistant to high levels of vancomycin can be readily isolated from the feces of domestic animals in Europe (2, 10) and from humans with no exposure to hospitals (17, 31). There has been no report of high-level vancomycin resistance (Ͼ32 g/ml) in Enterococcus spp. from animal feces or from humans without hospital exposure in the United States. In spite of a 1997 call for the investigation of sources of VRE outside the health care setting in the United States (21), there are remarkably few publications containing such data (8). VRE that are intrinsically resistant to low levels of vancomycin, such as E. gallinarum, E. casseliflavus, and E. flavescens, have been isolated from bird feces (30), and E. gallinarum containing the vanC gene has been isolated from chickens and farm lagoons (8).As part of another study (18), our laboratory isolated thousands of fecal streptococci (a group that includes Enterococcus spp. and other group D Streptococcus spp.) from animal feces, wastewater, and surface waters. Some of these isolates were resistant to high levels (Ͼ32 g/ml) of vancomycin. In order to investigate the presence of VRE in wastewater, animal feces, and surface waters, all VRE were identified to the genus and species level.Isolation of vancomycin-resistant fecal streptococci. Fecal streptococcus isolates were obtained from the feces of cattle, chickens, dogs, pigs, and wild animals (birds and raccoons). Fecal streptococci were also isolated from wastewater samples collected at a central sewer lift station (designated LF)...

Microbiological evaluation of fecal bacterial composition from surface water through aquifer sand material

“…in environmental waters other than sewage, including animal waste (Devriese et al 1987(Devriese et al , 1991Sinton et al 1993;Harwood et al 2001), invertebrates (Svec et al 2002) and plants (Muller et al 2001). Other sources may be resuspended survivors from sediments (Grant et al 2001;Le Fevre & Lewis 2003) and soils (Fujioka et al 1999).…”

E. coli and Coliform Bacteria as Indicators for Drinking Water Quality and Handling of Drinking Water in the Sagarmatha National Park, Nepal

“…However, isolating and identifying these organisms can be complicated, expensive and is rarely quantitative (Cairneross et al 1980;WHO 1983). Fortunately, measuring coliform bacteria (total coliform bacteria and/or fecal coliforms (in this case E. coli)) represents an indirect approach to measuring fecal contamination based on the assumption that these normal enteric organisms will indicate the level of fecal contamination of the water supply (WHO 1983;Pathak and Gopal, 2001;Harwood et al 2001;Vaidya et al 2001;Kistemann et al 2002). When combined with other indicators such as the physical characteristics of the water as well as distribution and access to water, the presence of bacteria can be used to help identify the reasons behind the contamination.…”

“…The main focus of this research was fecal contamination of drinking water using E. coli as an indirect method to identify contamination by fecal material, which poses significant health risks (WHO 1983;Kistemann et al 2002;Pathak and Gopal, 2001;Harwood et al 2001;Vaidya et al 2001). Findings from the bacterial work showed significant E. coli and coliform contamination in the transported water supplies.…”

Healthcare associated vancomycin- resistant enterococci

“…In the United States from 2006 to 2007, 4% of vancomycinresistant E.faceium was healthcare-infections [3].VRE can be carried by healthy people who come into contact with the bacteria. The most likely place where such contact can occur is in the hospital although it is thought that a significant percentage of intensively farmed chicken also carry VRE [4,5].Compared with vancomycin susceptible enterococci(VSE),VRE infections cause more severe disease, increased mortality and have significant additional economic burden. Antibiotic treatment options for VRE are limited and pan-resistance can occur [6].Enterocooci with acquired transferable high level resistance to vancomycin were first detected in feces from two leukemia patients from Europe in 1986 [7].Hospital outbreaks were increasingly described over the next decade across Europe and the USA.…”