scholarly journals Survey of Antibiotic Resistance among Enterococci in North Rhine-Westphalia, Germany

1999 ◽  
Vol 37 (5) ◽  
pp. 1638-1641 ◽  
Author(s):  
R. R. Reinert ◽  
G. Conrads ◽  
J. J. Schlaeger ◽  
G. Werner ◽  
W. Witte ◽  
...  

A surveillance study on antibiotic resistance of enterococcal isolates (n = 730) was carried out in North Rhine-Westphalia, Germany, in 1997. Resistance rates to ampicillin (7.4%), high-level gentamicin (15.0%), high-level streptomycin (27.9%), ciprofloxacin (37.9%), vancomycin (1.5%), and teicoplanin (1.5%) were determined. All vancomycin-resistant enterococci (VRE) carried the vanA gene. SmaI andApaI macrorestriction patterns indicated an intra- and interhospital spread of VRE.

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255187
Author(s):  
Mushtaq T. S. AL Rubaye ◽  
Jessin Janice ◽  
Jørgen Vildershøj Bjørnholt ◽  
Aleksandra Jakovljev ◽  
Maria Elisabeth Hultström ◽  
...  

Background Vancomycin-resistant enterococci (VRE) represent several types of transferable vancomycin resistance gene clusters. The vanD type, associated with moderate to high level vancomycin resistance, has only sporadically been described in clinical isolates. The aim of this study was to perform a genetic characterization of the first VanD-type VRE strains detected in Norway. Methods The VanD-type VRE-strains (n = 6) from two patient cases were examined by antimicrobial susceptibility testing and whole genome sequencing (WGS) to uncover Van-phenotype, strain phylogeny, the vanD gene clusters, and their genetic surroundings. The putative transferability of vanD was examined by circularization PCR and filter mating. Results The VanD-type Enterococcus faecium (n = 4) and Enterococcus casseliflavus (n = 2) strains recovered from two cases (A and B), expressed moderate to high level vancomycin resistance (MIC 64—>256 mg/L) and various levels of teicoplanin susceptibility (MIC 2—>256 mg/L). WGS analyses revealed phylogenetically different E. faecium strains (A1, A2, and A3 of case A and B1 from case B) as well as vanD gene clusters located on different novel genomic islands (GIs). The E. casseliflavus strains (B2 and B3 of case B) were not clonally related, but harbored nearly identical novel GIs. The vanD cluster of case B strains represents a novel vanD-subtype. All the vanD-GIs were integrated at the same chromosomal site and contained genes consistent with a Clostridiales origin. Circular forms of the vanD-GIs were detected in all strains except B1. Transfer of vanD to an E. faecium recipient was unsuccessful. Conclusions We describe the first VanD-type E. casseliflavus strains, a novel vanD-subtype, and three novel vanD-GIs with a genetic content consistent with a Clostridiales order origin. Despite temporal occurrence, case A and B E. faecium strains were phylogenetically diverse and harbored different vanD subtypes and vanD-GIs.


2021 ◽  
pp. 3-5
Author(s):  
Sunita Agarwal ◽  
Nazneen Pathan ◽  
Shivra Batra ◽  
Rajni Sharma

Introduction: The emergence of High Level Aminoglycoside Resistance (Resistant to Gentamycin and Streptomycin) and Vancomycin Resistant Enterococci among Indoor and Intensive Care Unit admitted patient presents a serious challenge for clinicians. Objective: To determine Enterococcal burden in blood and urine specimens and to detect the prevalence of High Level Aminoglycoside Resistance and Vancomycin Resistant Enterococci. Material & Methods: One hundred ten Enterococci were isolated from blood and urine samples and processed according to standard laboratory protocol. Species identication and sensitivity was done using the VITEK 2 automated system (Biomerieux France) with the cards GPID and AST 67 respectively. Results: Out of 110 Enterococci isolates, 36 were from blood and 74 from urine were detected. Different Species isolated were Enterococcal faecium (59%), Enterococcal faecalis (34%), Enterococcal rafnosus (2.7%), Enterococcal gallinarum (1.8%), Enterococcal casseliavus (0.9%) and Enterococcal duran (0.9%).Out of 36 blood isolates, 14 (38%) were found to be both High Level Gentamycin Resistant (HLGR) & High Level Streptomycin Resistant (HLSR), 10 (27%) were only HLGR and 8 (22%) were only HLSR. 20 strain (55%) of Enterococcus species isolated in blood were VRE. All VRE strains were found to be resistant to both aminoglycosides ( HLAR).Among the 74 urinary isolates, 24 (34%) were found to be both HLGR & HLSR, only HLGR was observed in 20 (27%) and HLSR was observed in 11 (14%) isolates. 24 strains (34%) of Enterococcus species were found to be vancomycin resistant in urine. 23 strains out of 24 were resistant to high level of aminoglycosides. Conclusion: The prevalence of HLAR and VRE is very high among Enterococcus specimens from indoor/ intensive care unit patients. Early species identication and antibiotic sensitivity result can help in better clinical outcome.


2019 ◽  
Vol 144 (08) ◽  
pp. 553-560 ◽  
Author(s):  
Alexander Mischnik ◽  
Guido Werner ◽  
Jennifer Bender ◽  
Nico Mutters

AbstractEnterococci with special resistance patterns (mainly vancomycin-resistant enterococci) play an important role in everyday clinical practice. Rising resistance rates to linezolid, daptomycin or tigecycline are also increasingly reported. Therapeutically, linezolid and daptomycin are the most important substances mainly in infections due to vancomycin-resistant enterococci. Several systematic meta-analyses of bloodstream infections showed discrepant results in the comparison of mortality of linezolid and daptomycin-treated bacteraemias. The containment of enterococci with special resistance patterns is currently receiving great attention. The key hygienic issue in all recommendations for dealing with multidrug-resistant enterococci can be summarized very simply: current scientific evidence is often inconsistent and studies that have clearly tested a single intervention for efficacy are lacking. The present work gives an insight into the current epidemiology and therapeutic strategies. Furthermore, the recently published German KRINKO recommendations are presented.


1989 ◽  
Vol 103 (1) ◽  
pp. 173-181 ◽  
Author(s):  
A. H. C. Uttley ◽  
R. C. George ◽  
J. Naidoo ◽  
N. Woodford ◽  
A. P. Johnson ◽  
...  

SUMMARYNosocomial infection or colonization due to enterococci with high-level resistance to vancomycin (minimal inhibitory concentrations [MICs] between 64 and > 2000 mg/L) has occurred in 41 patients with renal disease. These vancomycin-resistant enterococci were cultured from many sources including blood. All but one strain contained one or more plasmids ranging in molecular weight from 1·0 to 40 Megadaltons (MDa). Vancomycin resistance was transferable by conjugation to a susceptible recipient strain ofEnterococcus faecalisbut this was not always associated with plasmid DNA. The emergence of transferable high-level vancomycin resistance in enterococci causing significant clinical infections is of particular importance since vancomycin is widely regarded as a reserve drug for the management of infections with multi-resistant Gram-positive organisms.


2013 ◽  
Vol 37 ◽  
pp. 588-593 ◽  
Author(s):  
Figen ÇETİNKAYA ◽  
Tülay ELAL MUŞ ◽  
Gül Ece SOYUTEMİZ ◽  
Recep ÇIBIK

2019 ◽  
Vol 13 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Fakhri Haghi ◽  
Neda Shirmohammadlou ◽  
Rabab Bagheri ◽  
Sama Jamali ◽  
Habib Zeighami

Objectives:Enterococci are part of the microbial flora of the gastrointestinal tract of animals and human and can be released into the environment through fecal materials. These microorganisms play an important role in the dissemination of antibiotic resistance genes. Vancomycin-Resistant Enterococci (VRE) have been obtained in municipal sewage, hospital and agricultural wastes and healthy carriers. The aim of this study was to investigate the frequency of VRE in sewage and fecal samples of healthy carriers.Methods:This study was performed on fecal specimens of 100 healthy carriers and 100 samples of sewage in Zanjan Province. Fecal and sewage samples were cultured on Trypticase Soy Agar and biochemical tests were performed for Enterococci identification. Antimicrobial susceptibility testing was performed as CLSI guidelines and vancomycin resistance was determined using the agar dilution method.Result:Of 200 cultured samples, 141 isolates of Enterococci were detected. 64 isolates were detected from fecal and 77 were isolated from the sewage samples. Antibiotic resistance profile of fecal isolates was as follows: tetracycline (57.8%), ciprofloxacin (54.7%), phosphomycin (54.7%), erythromycin (51.5%), chloramphenicol (12.5%), amoxicillin (21.8%) and gatifloxacin (23.5%). Also for the sewage samples, the most antibiotic resistance was detected against ciprofloxacin (76.6%) followed by tetracycline (74%), erythromycin (68.8%), phosphomycin (61%). According to Agar dilution method, among 141 isolates of Enterococci, 15 (10.6%) isolates were vancomycin resistant: 11 of sewage isolates (14.3%) and 4 of the carrier isolates (6.2%).Conclusion:Our study describes the high frequency of VRE in municipal sewage and healthy carriers. Regarding the importance of VRE strains in the clinical and environment, it seems necessary to follow up on the issue.


2019 ◽  
Vol 6 (12) ◽  
pp. 310-315
Author(s):  
Nergis Aşgın ◽  
Emre Taşkın

Objective: In this study, we aim to determine the frequency of antibiotic resistance and five virulence genes in Enterococcus species and the relationship between antibiotic resistance and virulence genes. Material and Methods: A total of 86 Enterococcus strains isolated from inpatients between 2015 and 2016 were included. Identification and antibiotic susceptibilities of strains were determined using a BD Phoenix fully automated system. The presence of virulence-associated genes (esp, gel E, asa1, hyl, and cyl) were investigated by using PCR method. Results: Of the 86 Enterococcus strains, 53 (61.6%) and 33 (38.4%) were Enterococcus faecium and Enterococcus faecalis, respectively. Vancomycin and high-level gentamicin resistance (HLGR) in E. faecalis strains were 0.6% and 60.6%, respectively. Furthermore, 52 of the 53 E. faecium strains were both vancomycin-resistant and HLGR. The frequency of esp, gel E, asa1, cyl, and hyl was 91.9%, 60.5%, 54.7%, 43%, and 26.7%, respectively.  The asa 1, cyl, and gel E genes were detected at high frequencies in vancomycin-susceptible and non-HLGR strains, whereas hyl gene was detected at high frequencies in vancomycin-resistant and HLGR strains. Conclusion: Virulence genes were more frequent in vancomycin-susceptible and non-HLGR Enterococcus strains than in the resistant strains. Although infections caused by multidrug-resistant strains are difficult to treat, it should be considered that susceptible strains have more virulence genes. This may reduce the in vivo efficacy of drugs and lead to treatment failures. Therefore, in addition to the in vitro susceptibilities of drugs, clinical efficacy should be monitored.


Author(s):  
Harshad Singh Naruka ◽  
Anita E. Chand ◽  
Pradhuman Singh Chauhan ◽  
Danish Mukhtar

Background: Enterococci are common commensal organism of enteric tract and act as opportunistic pathogen and may cause infection in community as well as in hospitalised individuals. In present study association of several types of virulence factors like haemolysin, gelatinase and biofilm formation have been studied among HLAR and Vancomycin resistant Enterococci (VRE) isolates of enterococci among UTI patients.Methods: The samples were collected from all hospitalized and OPD patients of MBS Hospital, JK Lone Hospital and NMC Hospital. Government Medical College, Kota, Rajasthan, India. A total of 360 isolates of enterococcus were collected during the period of 2 years from April 2016 to April 2018 in microbiology laboratory, Department of Microbiology, Government Medical College, Kota, Rajasthan, India. All virulence factors were detected by phenotypic methods and MIC values were detected for high level gentamicin and vancomycin.Results: Among all enterococcal isolates most common factor was biofilm production 191 (53.05%) followed by haemolysin 131 (36.38%) and gelatinase production 72 (20%). Total resistant (MIC> 500 µg/ml) isolates for gentamicin was 194 (89.4%). In agar dilution 14 (11.2%) isolates were found sensitive, 61 (48.8%) isolates were found intermediate and 50 (40%) isolates were found to be resistant for vancomycin. HLAR and VRE was maximum associated with haemolysin + bio-film followed by gelatinase+biofilm, haemolysin+gelatinase+bio- film and least with haemolysin + gelatinase.Conclusions: In present study enterococcus show significant production of biofilm and other virulence factors. With production of biofilm they become more resistant to routinely used concentration of antibiotics posing threat for treatment failure. A continuous monitoring is needed particularly for resistance to aminoglycoside and vancomycin to stop their institutional spread. Judicial use of antibiotics should be encouraged both in community as well as in institutions.


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