scholarly journals Detection of various virulence factors in high level aminoglycoside resistance and vancomycin resistant enterococci isolates of uropathogenic Enterococci

2019 ◽  
Vol 7 (5) ◽  
pp. 1740
Author(s):  
Harshad Singh Naruka ◽  
Anita E. Chand ◽  
Pradhuman Singh Chauhan ◽  
Danish Mukhtar
Keyword(s):  
Virulence Factors ◽  
Common Factor ◽  
Opportunistic Pathogen ◽  
Government Medical College ◽  
Aminoglycoside Resistance ◽  
Medical College ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Study Association ◽  
High Level

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.

PREVALENCE OF HIGH LEVEL AMINOGLYCOSIDE RESISTANCE AND VANCOMYCIN RESISTANT ENTEROCOCCI IN ENTEROCOCCAL ISOLATES IN A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 3-5
Author(s):  
Sunita Agarwal ◽  
Nazneen Pathan ◽  
Shivra Batra ◽  
Rajni Sharma
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tertiary Care ◽  
Automated System ◽  
Care Hospital ◽  
Enterococcus Species ◽  
Aminoglycoside Resistance ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
High Level

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.

scholarly journals Frequency of vancomycin-resistant Enterococci isolated from blood cultures from 2008 to 2010

2011 ◽  
Vol 64 (9-10) ◽  
pp. 481-485 ◽  
Author(s):  
Mira Mihajlovic-Ukropina ◽  
Deana Medic ◽  
Zora Jelesic ◽  
Vera Gusman ◽  
Biljana Milosavljevic
Keyword(s):  
Antimicrobial Agents ◽  
Multidrug Resistant ◽  
Blood Cultures ◽  
Hospitalized Patients ◽  
Diffusion Method ◽  
Aminoglycoside Resistance ◽  
Vancomycin Resistant Enterococci ◽  
Enterococcus Spp ◽  
Vancomycin Resistant ◽  
High Level

Introduction. Enterococci are important hospital-acquired pathogens. The most commonly isolated species of the genus, Enterococcus faecalis and Enterococcus faecium are the third to fourth-most prevalent nosocomial pathogens worldwide. The aim of this study was to determine the frequency of resistance to vancomycin and other antimicrobial agents of Enterococcus spp strains isolated from blood cultures of hospitalized patients. Material and methods. During the three-year period, from 2008 to 2010, 132 strains of Enterococcus spp isolated from blood cultures of hospitalized patients were tested for their susceptibility to ampicillin, vancomycin, gentamycin (high-level resistance), erythromycin, chloramphenicol, teicoplanin, ciprofloxacin by disc diffusion method according to the Clinical and Laboratory Standards Institute recommendations. Susceptibility of vancomycin resistant E. faecium to the same antibiotics and to linezolid, quinopristin/dalfopristin and tigecyclin was determined using VITEK system. Results and discussion. Resistance to vancomycin was detected in 21 (15.9%) Enterococcus spp strains. The percentage of resistance to other antimicrobial agents varied from 23.1% for chloramphenicol to 81.3% for ciproflxacin. All vancomycin resistant enterococci were identified as E. faecium and belonged to phenotype VanA. The resistance to other antibiotics was very high, except for linezolid and quinopristin/dalfopristin (4.7%). The high-level aminoglycoside resistance was 87.6% for gentamycin and 95.2% for streptomycin. All isolates were resistant to ampicillin, teicoplanin and ciprofloxacin. Conclusion. The detected high frequency of multidrug-resistant isolates among vancomycin resistant enterococci is of great importance and suggests the need for further monitoring of susceptibility in order to take adequate measures to prevent and control spreading of resistant strains.

scholarly journals Novel genomic islands and a new vanD-subtype in the first sporadic VanD-type vancomycin resistant enterococci in Norway

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 ◽  
...  
Keyword(s):  
Gene Clusters ◽  
Vancomycin Resistance ◽  
Genomic Islands ◽  
Vancomycin Resistant Enterococci ◽  
Chromosomal Site ◽  
Enterococcus Casseliflavus ◽  
Temporal Occurrence ◽  
Vancomycin Resistant ◽  
High Level

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.

scholarly journals Exploring Virulence Factors and Alternative Therapies against Staphylococcus aureus Pneumonia

Toxins ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 721
Author(s):  
Jelle Vlaeminck ◽  
Dina Raafat ◽  
Kristin Surmann ◽  
Leen Timbermont ◽  
Nicole Normann ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Virulence Factors ◽  
Financial Burden ◽  
Opportunistic Pathogen ◽  
Vaccine Research ◽  
Potential Significance ◽  
Associated Proteins ◽  
Alternative Approaches ◽  
Staphylococcus Aureus Pneumonia ◽  
High Level

Pneumonia is an acute pulmonary infection associated with high mortality and an immense financial burden on healthcare systems. Staphylococcus aureus is an opportunistic pathogen capable of inducing S. aureus pneumonia (SAP), with some lineages also showing multidrug resistance. Given the high level of antibiotic resistance, much research has been focused on targeting S. aureus virulence factors, including toxins and biofilm-associated proteins, in an attempt to develop effective SAP therapeutics. Despite several promising leads, many hurdles still remain for S. aureus vaccine research. Here, we review the state-of-the-art SAP therapeutics, highlight their pitfalls, and discuss alternative approaches of potential significance and future perspectives.

scholarly journals High-level vancomycin-resistant enterococci causing hospital infections

1989 ◽  
Vol 103 (1) ◽  
pp. 173-181 ◽  
Author(s):  
A. H. C. Uttley ◽  
R. C. George ◽  
J. Naidoo ◽  
N. Woodford ◽  
A. P. Johnson ◽  
...  
Keyword(s):  
Plasmid Dna ◽  
Vancomycin Resistance ◽  
Recipient Strain ◽  
Hospital Infections ◽  
Minimal Inhibitory Concentrations ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Many Sources ◽  
High Level ◽  
Level Resistance

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.

scholarly journals In Vitro Antimicrobial Activity of Fosfomycin, Rifampin, Vancomycin, Daptomycin Alone and in Combination Against Vancomycin-Resistant Enterococci

2021 ◽  
Author(s):  
Wei Yu ◽  
Yiheng Jiang ◽  
Hao Xu ◽  
Li Zhang ◽  
Xuehang Jin ◽  
...  
Keyword(s):  
Virulence Genes ◽  
Therapeutic Option ◽  
Bactericidal Effect ◽  
Resistance Determinant ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
High Level ◽  
Time Kill ◽  
Level Resistance

Abstract OBJECTIVESThe emergence of vancomycin resistant enterococci (VRE) is shortening the choices for clinical anti-infective therapy. The aim of this study was to investigate the mechanism of vancomycin resistance and evaluate the effect of fosfomycin (FM), rifampin (RIF), vancomycin (VAN), linezolid (LNZ), daptomycin (DAP) alone or in combination against VRE.METHODSEight VRE isolates were collected. A total of 18 antibiotics susceptibility tests were further done for VRE. Whole genome sequencing and bioinformatics analysis were performed. The effect of FM, RIF, VNA, LNZ, DAP alone or in combination was determined using anti-biofilm testing and the time-kill assay.RESULTSAll isolates were susceptible to LNZ and DPA. The high-level resistance determinant of VAN in these strains was due to VanA-type cassette. MLST revealed two different STs for vancomycin-resistant Enterococcus faecium (VREm) and four different STs for vancomycin-resistant E. faecalis (VREs). Virulence genes in VREs were more than VREm, especially for 4942 isolated from blood. Gene acm and uppS were only identified in VREm, while virulence genes related to cytolysin were only found in E. faecalis. Further in vitro anti-biofilm testing and time-kill assay found FM (83 mg/L) combined with DAP (20.6 mg/L) and DAP monotherapy (47.1 mg/L) showed bactericidal effect against 8 tested VRE strains at 24h. CONCLUSIONSThe high-level resistance determinant of VAN in these strains was due to VanA-type cassette. FM combined with DAP might be greater potential therapeutic option against VRE.

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 ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Surveillance Study ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
High Level ◽  
Resistance Rates

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.

Prevalence of high-level vancomycin-resistant enterococci in French broilers and pigs

2008 ◽  
Vol 32 (5) ◽  
pp. 463-464 ◽  
Author(s):  
Isabelle Kempf ◽  
Gwenaëlle Hellard ◽  
Agnès Perrin-Guyomard ◽  
Mireille Gicquel-Bruneau ◽  
Pascal Sanders ◽  
...  
Keyword(s):  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
High Level

scholarly journals A Comparison of High-Level Aminoglycoside Resistance in Vancomycin-Sensitive and Vancomycin-Resistant Enterococcus Species

2002 ◽  
Vol 30 (5) ◽  
pp. 529-534 ◽  
Author(s):  
H Yazgi ◽  
M Ertek ◽  
S Erol ◽  
A Ayyildiz
Keyword(s):  
Brain Heart Infusion ◽  
Bactericidal Effect ◽  
Vancomycin Resistance ◽  
Glycopeptide Antibiotics ◽  
Aminoglycoside Resistance ◽  
Significant Difference ◽  
Vancomycin Resistant ◽  
High Level ◽  
Infusion Agar ◽  
Level Resistance

The aim of this study was to investigate whether there was a significant difference in high-level aminoglycoside resistance (HLAR) between vancomycin-sensitive enterococci (VSE) and vancomycin-resistant enterococci (VRE). Vancomycin resistance was determined in 116 Enterococcus isolates using brain-heart infusion agar containing 6 μg/ml vancomycin. HLAR was determined by both standard agar screening and disk diffusion methods. Streptomycin and gentamicin were used as predictors of HLAR. Vancomycin resistance and HLAR were found in 17 (14.7%) and 41 (35.3%) of the Enterococcus strains, respectively. HLAR was found in 11 of 17 VRE and 30 of 98 VSE strains. HLAR in VRE strains was significantly higher than in VSE. More enterococcal strains were found to be resistant to both gentamicin and streptomycin (29) than to gentamicin (one) or streptomycin (11) alone. The HLAR rate in VRE was two-fold higher than in VSE. The synergistic bactericidal effect of aminoglycosides and β-lactam or glycopeptide antibiotics is lost if there is high-level resistance to aminoglycosides.

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