STATUS OF HIGH LEVEL AMINOGLYCOSIDE RESISTANT ENTEROCOCCUS FAECIUM AND ENTEROCOCCUS FAECALIS IN A RURAL HOSPITAL OF CENTRAL INDIA

This study was conducted to characterize the antimicrobial resistance determinants and investigate plasmid colocalization of tetracycline and macrolide genes in Enterococcus faecalis and Enterococcus faecium from broiler chicken and turkey flocks in Canada. A total of 387 E. faecalis and E. faecium isolates were recovered from poultry cecal contents from five processing plants. The percentages of resistant E. faecalis and E. faecium isolates, respectively, were 88.1 and 94% to bacitracin, 0 and 0.9% to chloramphenicol, 0.7 and 14.5% to ciprofloxacin, 72.6 and 80.3% to erythromycin, 3.7 and 41% to flavomycin, 9.6 and 4.3% (high-level resistance) to gentamicin, 25.2 and 17.1% (high-level resistance) to kanamycin, 100 and 94% to lincomycin, 0 and 0% to linezolid, 2.6 and 20.5% to nitrofurantoin, 3 and 27.4% to penicillin, 98.5 and 89.7% to quinupristin-dalfopristin, 7 and 12.8% to salinomycin, 46.7 and 38.5% (high-level resistance) to streptomycin, 95.6 and 89.7% to tetracycline, 73 and 75.2% to tylosin, and 0 and 0% to vancomycin. One predominant multidrug-resistant phenotypic pattern was identified in both E. faecalis and E. faecium (bacitracin, erythromycin, lincomycin, quinupristin-dalfopristin, tetracycline, and tylosin). These isolates were further examined by PCR and sequencing for the genes encoding their antimicrobial resistance. Various combinations of vatD, vatE, bcrR, bcrA, bcrB, bcrD, ermB, msrC, linB, tetM, and tetO genes were detected, and ermB, tetM, and bcrB were the most common antimicrobial resistance genes identified. For the first time, plasmid extraction and hybridization revealed colocalization of tetO and ermB genes on a ca. 11-kb plasmid in E. faecalis isolates, and filter mating experiments demonstrated its transferability. Results indicate that the intestinal enterococci of healthy poultry, which can contaminate poultry meat at slaughter, could be a reservoir for quinupristin-dalfopristin, bacitracin, tetracycline, and macrolide resistance genes.

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Antimicrobial resistance of Enterococcus faecium and Enterococcus faecalis, isolated from blood culture of patients with hematological malignancies during different study periods

Oncohematology ◽

10.17650/1818-8346-2021-16-1-54-63 ◽

2021 ◽

Vol 16 (1) ◽

pp. 54-63

Author(s):

A. V. Fedorova ◽

G. A. Klyasova ◽

I. N. Frolova ◽

S. A. Khrulnova ◽

A. V. Vetokhina ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Blood Culture ◽

Enterococcus Faecalis ◽

Enterococcus Faecium ◽

Dilution Method ◽

Agar Dilution Method ◽

High Susceptibility ◽

Microdilution Method ◽

Broth Microdilution Method ◽

High Level

Objective: to determine antimicrobial resistance of Enterococcus faecium and Enterococcus faecalis isolated from blood culture of hematological patients during different study periods.Materials and methods. Antimicrobial susceptibility of Enterococcus spp., collected as part of the multicenter study was tested by the broth microdilution method (USA Clinical and Laboratory Standards Institute (CLSI), 2018), to daptomycin by Etest (bioMeriéux, France). High-level gentamicin resistance (HLGR) and high-level streptomycin resistance (HLSR) was performed by the agar dilution method (CLSI (Oxoid, UK), 2018).Results. The susceptibility of 366 E. faecium (157 in 2002-2009 and 209 in 2010-2017) and 86 E. faecalis (44 in 20022009 and 42 in 2010-2017) was studied. In the second study period (2010-2017) the rise of vancomycin-resistant E. faecium (VREF) increased from 8.3 % to 23.4 % (p = 0.0001), and two linezolid-resistant (LREF) were identified. All VREF and LREF remained susceptible to daptomycin and tigecycline. The rate of susceptible to tetracycline E. faecium remained the same (73.9 and 74.6 %), and an increase in susceptibility to chloramphenicol (74.5 and 82.3 %) was observed. Susceptibility of E. faecium to tetracycline was detected with almost the same rate and in a part of isolates, the increase of susceptibility to chloramphenicol was registered during the analyzed periods. The rise of E. faecium susceptible to HLGR and HLSR has increased significantly in 2010-2017 compared to 2002-2009. Erythromycin, levofloxacin, ampicillin and penicillin had the least activity against E. faecium (less than 5 %).All E. faecalis were susceptible to tigecycline, linezolid, and teicoplanin. Only one of E. faecalis had intermediate resistance to vancomycin. High susceptibility to ampicillin in E. faecalis remained unchanged (97.7 and 97.6 %, respectively). In the second period of the study the rise of susceptible E. faecalis decreased significantly to penicillin (from 97.7 % to 76.2 %), to levofloxacin (from 59.1 % to 31 %), to HLSR (from 52.3 % до 31 %), and to HLGR (from 47.7 % to 26.2 %), remained unchanged to chloramphenicol (52.3 % and 50 %) and was minimal to erythromycin and tetracycline.Conclusion. The study demonstrated higher rates of antibiotic resistance among E. faecium, which consisted of an increase in VREF and the appearance of linezolid-resistant strains. High susceptibility to ampicillin remained in E. faecalis, but there was an increase in resistance to penicillin and aminoglycosides.

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Status of high level aminoglycoside resistantEnterococcus faeciumandEnterococcus faecalisin a rural hospital of central India

Indian Journal of Medical Microbiology ◽

10.4103/0255-0857.43582 ◽

2008 ◽

Vol 26 (4) ◽

pp. 369 ◽

Cited By ~ 14

Author(s):

DK Mendiratta ◽

H Kaur ◽

V Deotale ◽

DC Thamke ◽

R Narang ◽

...

Keyword(s):

Central India ◽

Rural Hospital ◽

High Level

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Alterations in GyrA and ParC Associated with Fluoroquinolone Resistance in Enterococcus faecium

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.43.4.947 ◽

1999 ◽

Vol 43 (4) ◽

pp. 947-949 ◽

Cited By ~ 43

Author(s):

Nagwa el Amin ◽

Shah Jalal ◽

Bengt Wretlind

Keyword(s):

Enterococcus Faecalis ◽

Resistant Strain ◽

Enterococcus Faecium ◽

The Other ◽

Fluoroquinolone Resistance ◽

Topoisomerase Iv ◽

Gram Positive Bacteria ◽

Efflux Mechanism ◽

Resistant Strains ◽

High Level

ABSTRACT High-level quinolone resistance in Enterococcus faeciumwas associated with mutations in both gyrA andparC genes in 10 of 11 resistant strains. One low-level resistant strain without such mutations may instead possess an efflux mechanism or alterations in the other subunits of the gyrase or topoisomerase IV genes. These findings are similar to those for other gram-positive bacteria, such as Enterococcus faecalis.

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Distribution of aminoglycoside resistance genes in recent clinical isolates of Enterococcus faecalis, Enterococcus faecium and Enterococcus avium

Epidemiology and Infection ◽

10.1017/s0950268801005271 ◽

2001 ◽

Vol 126 (2) ◽

pp. 197-204 ◽

Cited By ~ 61

Author(s):

N. KOBAYASHI ◽

MD. MAHBUB ALAM ◽

Y. NISHIMOTO ◽

S. URASAWA ◽

N. UEHARA ◽

...

Keyword(s):

Enterococcus Faecalis ◽

Enterococcus Faecium ◽

Clinical Isolates ◽

University Hospital ◽

Aminoglycoside Resistance ◽

Genes Encoding ◽

Enterococcal Species ◽

Aminoglycoside Resistance Genes ◽

Major Factors ◽

High Level

Aminoglycoside modifying enzymes (AMEs) are major factors which confer aminoglycoside resistance on bacteria. Distribution of genes encoding seven AMEs was investigated by multiplex PCR for 279 recent clinical isolates of enterococci derived from a university hospital in Japan. The aac(6′)-aph(2″), which is related to high level gentamicin resistance, was detected at higher frequency in Enterococcus faecalis (42·5 %) than in Enterococcus faecium (4·3 %). Almost half of E. faecalis and E. faecium isolates possessed ant(6)-Ia and aph(3′)-IIIa. The profile of AME gene(s) detected most frequently in individual strains of E. faecalis was aac(6′)-aph(2″)+ant(6)-Ia+aph(3′)-IIIa, and isolates with this profile showed high level resistance to both gentamicin and streptomycin. In contrast, AME gene profiles of aac(6′)-Ii+ant(6)-Ia+aph(3′)-IIIa, followed by aac(6′)-Ii alone, were predominant in E. faecium. Only one AME gene profile of ant(6)-Ia+aph(3′)-IIIa was found in Enterococcus avium. The ant(4′)-Ia and ant(9)-Ia, which have been known to be distributed mostly among Staphylococcus aureus strains, were detected in a few enterococcal strains. An AME gene aph(2″)-Ic was not detected in any isolates of the three enterococcal species. These findings indicated a variety of distribution profiles of AME genes among enterococci in our study site.

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Detection of virulence factors in high-level gentamicin-resistant Enterococcus faecalis and Enterococcus faecium isolates from a Tunisian hospital

Canadian Journal of Microbiology ◽

10.1139/w06-136 ◽

2007 ◽

Vol 53 (3) ◽

pp. 372-379 ◽

Cited By ~ 17

Author(s):

N. Klibi ◽

K. Ben Slama ◽

Y. Sáenz ◽

A. Masmoudi ◽

S. Zanetti ◽

...

Keyword(s):

Enterococcus Faecalis ◽

Virulence Factors ◽

Enterococcus Faecium ◽

Biofilm Formation ◽

Virulence Genes ◽

Virulence Gene ◽

Gelatinase Activity ◽

Genes Encoding ◽

High Level

Phenotypic and genotypic determination of virulence factors were carried out in 46 high-level gentamicin-resistant (HLGR) clinical Enterococcus faecalis (n = 34) and Enterococcus faecium (n = 12) isolates recovered from different patients in La Rabta Hospital in Tunis, Tunisia, between 2000 and 2003 (all these isolates harboured the aac(6′)–aph(2″) gene). The genes encoding virulence factors (agg, gelE, ace, cylLLS, esp, cpd, and fsrB) were analysed by PCR and sequencing. The production of gelatinase and hemolysin, the adherence to caco-2 and hep-2 cells, and the capacity for biofilm formation were investigated in all 46 HLGR enterococci. The percentages of E. faecalis isolates harbouring virulence genes were as follows: gelE, cpd, and ace (100%); fsrB (62%); agg (56%); cylLLS (41.2%); and esp (26.5%). The only virulence gene detected among the 12 HLGR E. faecium isolates was esp (58%). Gelatinase activity was detected in 22 of the 34 E. faecalis isolates (65%, most of them with the gelE+–fsrB+ genotype); the remaining 12 isolates were gelatinase-negative (with the gelE+–fsrB– genotype and the deletion of a 23.9 kb fragment of the fsr locus). Overall, 64% of the cylLLS-containing E. faecalis isolates showed β-hemolysis. A high proportion of our HLGR E. faecalis isolates, in contrast to E. faecium, showed moderate or strong biofilm formation or adherence to caco-2 and hep-2 cells.

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Antibiotic resistance of hospital strains of Enterococcus faecalis and Enterococcus faecium

Vojnosanitetski pregled ◽

10.2298/vsp0205499m ◽

2002 ◽

Vol 59 (5) ◽

pp. 499-506 ◽

Cited By ~ 2

Author(s):

Veljko Mirovic

Keyword(s):

Enterococcus Faecalis ◽

Enterococcus Faecium ◽

Clinical Laboratory ◽

Streptomycin Resistance ◽

National Committee ◽

High Incidence ◽

Gentamicin Resistance ◽

Vancomycin Resistant ◽

High Level ◽

Very High

The aim of this study was to determine the resistance of Enterococcus faecalis (E. faecalis) and Enterococcus faecium (E. faecium) to penicillin, ampicillin, vancomycin, teicoplanin, gentamicin (high level), streptomycin (high level), oxytetracycline, chloramphenicol, rifampin, erythromycin, ciprofloxacin, norfloxacin, and nitrofurantoin from clinical specimens during 1999. The resistance of enterococci to antibiotics was determined by disk diffusion and dilution methods according to the American National Committee for Clinical Laboratory Standards guidelines. The production of ?-lactamase was determined by nitrocefin disks. In E. faecalis and E. faecium isolates (n=111 and n=48) the frequency of the resistance to both penicillins was 0.9% and 89.6%, respectively. All enterococci isolates were ?-lactamase negative. Only one strain of E. faecium was vancomycin resistant (Van A fenotype). Among E. faecalis isolates (n=109) high level gentamicin resistance (HLGR), high level streptomycin resistance (HLSR), and resistance to both agents was 52.3%, 50.4%, and 43.7%, respectively. Among E. faecium isolates (n=48) HLGR, HLSR, and to both agents were 68.7%, 75%, and 62.5% respectively. The majority of E. faecium isolates were resistant to both penicillin and ampicillin. E. faecalis remained susceptible to penicillins. Moreover, there was a very high incidence of enterococci resistant to high level aminoglycosides.

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