Molecular characterization and multilaboratory evaluation of Enterococcus faecalis ATCC 51299 for quality control of screening tests for vancomycin and high-level aminoglycoside resistance in enterococci.

The selection of the best alternative for Enterococcus faecalis infective endocarditis (IE) continuation treatment in the outpatient setting is still challenging. Three databases were searched, reporting antibiotic therapies against E. faecalis IE in or suitable for the outpatient setting. Articles the results of which were identified by species and treatment regimen were included. The quality of the studies was assessed accordingly with the study design. Data were extracted and synthesized narratively. In total, 18 studies were included. The treatment regimens reported were classified regarding the main antibiotic used as regimen, based on Aminoglycosides, dual β-lactam, teicoplanin, daptomycin or dalbavancin or oral therapy. The regimens based on aminoglycosides and dual β-lactam combinations are the treatment alternatives which gather more evidence regarding their efficacy. Dual β-lactam is the preferred option for high level aminoglycoside resistance strains, and for to its reduced nephrotoxicity, while its adaptation to the outpatient setting has been poorly documented. Less evidence supports the remaining alternatives, but many of them have been successfully adapted to outpatient care. Teicoplanin and dalbavancin as well as oral therapy seem promising. Our work provides an extensive examination of the potential alternatives to E. faecalis IE useful for outpatient care. However, the insufficient evidence hampers the attempt to give a general recommendation.

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High Level Aminoglycoside Resistance And Distribution Of The Resistance Genes In Enterococcus faecalis And Enterococcus faecium From Teaching Hospital In Malaysia

Infection and Drug Resistance ◽

10.2147/idr.s219544 ◽

2019 ◽

Vol Volume 12 ◽

pp. 3269-3274

Author(s):

Ayan Aden Moussa ◽

Amirah Fatihah Md Nordin ◽

Rukman Awang Hamat ◽

Azmiza Syawani Jasni

Keyword(s):

Enterococcus Faecalis ◽

Teaching Hospital ◽

Resistance Genes ◽

Enterococcus Faecium ◽

Aminoglycoside Resistance ◽

High Level

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Detection of a Streptomycin/Spectinomycin Adenylyltransferase Gene (aadA) in Enterococcus faecalis

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.43.1.157 ◽

1999 ◽

Vol 43 (1) ◽

pp. 157-160 ◽

Cited By ~ 105

Author(s):

Nancye C. Clark ◽

Ørjan Olsvik ◽

Jana M. Swenson ◽

Carol A. Spiegel ◽

Fred C. Tenover

Keyword(s):

Enterococcus Faecalis ◽

Pcr Primers ◽

Binding Assays ◽

Aminoglycoside Resistance ◽

Cycle Sequencing ◽

E Coli ◽

Genes Encoding ◽

Gram Negative Organisms ◽

High Level ◽

Rhodamine Dye

Genes encoding streptomycin/spectinomycin adenylyltransferases [ANT(3")(9)] have been reported to exist in gram-negative organisms and Staphylococcus aureus. During a study of high-level aminoglycoside resistance in enterococci, we encountered an isolate ofEnterococcus faecalis that was streptomycin resistant but did not appear to contain the 6′-adenylyltransferase gene (aadE) when examined by PCR with specific primers. Phosphocellulose paper binding assays indicated the presence of an ANT(3")(9) enzyme. Streptomycin and spectinomycin MICs of 4,000 and 8,000 μg/ml, respectively, were observed for the isolate. PCR primers corresponding to a highly conserved region of the aadA gene were used to amplify a specific 284-bp product. The product hybridized with a digoxigenin-labeled PCR product from E. coliC600(pHP45Ω) known to contain the aadA gene. TheaadA gene was transferred via filter matings from theE. faecalis donor to E. faecalisJH2-2. PCR primers designed for analysis of integrons were used to amplify a 1-kb product containing the aadA gene, which was cloned into the vector pCRII and transformed into Escherichia coli DH5-α competent cells. d-Rhodamine dye terminator cycle sequencing was used to determine the gene sequence, which was compared to previously reported sequences of aadAgenes. We found the aadA gene in E. faecalis to be identical to the aadA genes reported by Sundström et al. for E. coli plasmid R6-5 (L. Sundström, P. Rådström, G. Swedberg, and O. Sköld, Mol. Gen. Genet. 213:191–201, 1988), by Fling et al. for theaadA within transposon Tn7 (M. E. Fling, J. Kopf, and C. Richards, Nucleic Acids Res. 13:7095–7106, 1985), and by Hollingshead and Vapnek for E. coliR538-1 (S. Hollingshead and D. Vapnek, Plasmid 13:17–30, 1985). Previous reports of the presence of the aadA gene in enterococci appear to be erroneous and probably describe anaadE gene, since the isolates were reported to be susceptible to spectinomycin.

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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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Pheromone responses and high-level aminoglycoside resistance of conjugative plasmids of Enterococcus faecalis from Greece

Journal of Antimicrobial Chemotherapy ◽

10.1093/jac/46.6.1013 ◽

2000 ◽

Vol 46 (6) ◽

pp. 1013-1016 ◽

Cited By ~ 4

Author(s):

S. Pournaras

Keyword(s):

Enterococcus Faecalis ◽

Aminoglycoside Resistance ◽

Conjugative Plasmids ◽

High Level

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Outbreak of Infections in a Greek University Hospital Involving a Single Clone of High-Level Aminoglycoside-ResistantEnterococcus faecalis

Infection Control and Hospital Epidemiology ◽

10.1086/501737 ◽

2000 ◽

Vol 21 (12) ◽

pp. 786-789 ◽

Cited By ~ 3

Author(s):

Spyros Pournaras ◽

Athanassios Tsakris ◽

Mary E. Kaufmann ◽

John Douboyas ◽

Antonios Antoniadis

Keyword(s):

Enterococcus Faecalis ◽

Resistance Genes ◽

University Hospital ◽

Aminoglycoside Resistance ◽

Single Clone ◽

Aminoglycoside Resistance Genes ◽

High Level ◽

Level Resistance

Among 145Enterococcus faecalisisolates recovered during a 15-month period (April 1997-June 1998) in AHEPA University Hospital, Thessaloniki, Greece, 94 (65%) exhibited high-level resistance to gentamicin or streptomycin and 61 (42%) to both aminoglycosides; 73% of the high-level aminoglycoside-resistantE faecalisisolates belonged to a single clone carrying the geneaac(6')-Ie-aph(2”)-Ia. These findings differ from those of other regions, where high-level aminoglycoside-resistance genes are dispersed into genetically unrelated strains.

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Resistance pattern of enterococcus for high level aminoglycosides and vancomycin in blood culture of admitted patients

International Journal of Bioassays ◽

10.21746/ijbio.2016.01.0010 ◽

2016 ◽

Vol 5 (01) ◽

pp. 4756

Author(s):

Shadma Yaqoob

Keyword(s):

Blood Culture ◽

Multidrug Resistant ◽

Screening Tests ◽

Diffusion Method ◽

Resistance Pattern ◽

Aminoglycoside Resistance ◽

Vancomycin Resistant ◽

Blood Specimens ◽

High Level ◽

Clinical Conditions

Enterococci have emerged as important nosocomial pathogens from a variety of clinical conditions and the major reason for this is the trend of increasing antimicrobial resistance and enterococcal bacteraemia results in a high mortality. The present study was undertaken to determine the occurrence, species prevalence, antibacterial resistance, with a special reference to vancomycin and high level aminoglycoside resistance. Material and methods: The study was conducted on blood culture isolates. The antibiotic susceptibility of isolates by the Kirby Bauer disc diffusion method was done according to the CLSI guidelines. Screening tests for high level aminoglycosides and vancomycin and minimum inhibitory concentration (MIC) tests for vancomycin was done. The blood specimens were cultured and suspected growths were identified to species level and found to consist mostly of E. fecalis (70%). VRE accounted for 2 (91%) isolates and high level aminoglycoside resistance was seen in 47.82 and 60.86 isolates. The E. faecium isolates were more drug resistant than the E. faecalis isolates. Linezolid and Teicoplanin showed good anti-enterococcal activity. This study shows an emergence of Vancomycin resistant enterococcus (VRE) along with increased rate of multidrug-resistant enterococci. Regular surveillance of antimicrobial susceptibilities and treatment of enterococcal infections should be done effectively to limit the spread of multidrug resistance.

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