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

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.

Download Full-text

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.

Download Full-text

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

10.36106/gjra/5900236 ◽

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.

Download Full-text

Vancomycin and High Level Aminoglycoside Resistance inEnterococcusspp. in a Tertiary Health Care Centre: A Therapeutic Concern

Journal of Pathogens ◽

10.1155/2016/8262561 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 6

Author(s):

Seema Mittal ◽

Pooja Singla ◽

Antariksha Deep ◽

Kiran Bala ◽

Rama Sikka ◽

...

Keyword(s):

Antimicrobial Agents ◽

Antibiotic Sensitivity ◽

Vaginal Swab ◽

Control Measures ◽

Diffusion Method ◽

Clinical Samples ◽

Aminoglycoside Resistance ◽

Sensitivity Testing ◽

Health Care Centre ◽

High Level

Aims. This study was aimed at knowing the prevalence of vancomycin and high level aminoglycoside resistance in enterococcal strains among clinical samples.Study Design. It was an investigational study.Place and Duration of Study. It was conducted on 100Enterococcusisolates, in the Department of Microbiology, Pt. BDS PGIMS, Rohtak, over a period of six months from July to December 2014.Methodology. Clinical specimens including urine, pus, blood, semen, vaginal swab, and throat swab were processed andEnterococcusisolates were identified by standard protocols. Antibiotic sensitivity testing of enterococci was performed using Kirby-Bauer disc diffusion method.Results. High level gentamicin resistance (HLGR) was more common in urine samples (41.5%) followed by blood (36%) samples. High level streptomycin resistance (HLSR) was more common in pus samples (52.6%) followed by blood samples (36%). Resistance to vancomycin was maximum in blood isolates.Conclusion. Enterococci resistant to multiple antimicrobial agents have been recognized. Thus, it is crucial for laboratories to provide accurate antimicrobial resistance patterns for enterococci so that effective therapy and infection control measures can be initiated.

Download Full-text

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

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20191668 ◽

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.

Download Full-text

Antibiogram of Urinary Enterococcus isolates from a tertiary care hospital

Infectious Disorders - Drug Targets ◽

10.2174/1871526520666200403140618 ◽

2020 ◽

Vol 20 ◽

Author(s):

Nanditha Rajaram Bhat ◽

Shruthi Bhat Kodur Shivashankar ◽

Biranthabail Dhanashree

Keyword(s):

Tertiary Care ◽

Clinical Problem ◽

Diffusion Method ◽

Care Hospital ◽

Biochemical Tests ◽

Serious Infections ◽

Enterococcus Spp ◽

Agar Dilution ◽

Vancomycin Resistant ◽

High Level

Purpose: Urinary tract infection (UTI) is one of the serious infections caused by enterococci. VancomycinResistant Enterococci (VRE), is a persevering clinical problem globally. This study aims to detect high-level aminoglycoside and vancomycin resistance in uropathogenic Enterococcus spp. Methodology: A total of 75 clinically relevant Enterococcus spp. grown from urine samples, were collected following convenience non-random sampling method. Identified by standard biochemical tests and susceptibility to antibiotics was studied by Kirby Bauer’s disc diffusion method. The MIC of vancomycin was detected by agar dilution test. Van A, and Van B genes in VREs were detected by PCR. Results: Among the 75 Enterococcal isolates, 43 (57.3%) were E.faecalis, 12 (16%) were E.faecium, six (8%) each were E.pseudoavium and E.casseliflavus, five (6.66%) were E.dispar and three (4%) were E.durans. E.faecalis (n=19) and E.faecium (n=3) were resistant to High Level Streptomycin (HLS). E.faecalis (n=21) and E.faecium (n=6) were resistant to High Level Gentamicin (HLG). Four (9.3%) E.faecalis were vancomycin-resistant, of which three were of Van A, and one was both Van A and Van B genotype. Conclusion: Isolation of high level aminoglycoside resistant (HLAR) Enterococci is a challenge for the treating physician because aminoglycoside cannot be used in combination with glycopeptide or ampicillin for such isolates. The occurrence of HLAR, Van A and Van B VRE genotypes is a cause of concern as they may transfer drug resistance genes to other bacterial isolates, thus leading to limited therapeutic options.

Download Full-text

Biochemical and Molecular Analysis ofStaphylococcus aureusClinical Isolates from Hospitalized Patients

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2016/9041636 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 9

Author(s):

Amit Karmakar ◽

Parimal Dua ◽

Chandradipa Ghosh

Keyword(s):

Staphylococcus Aureus ◽

Antimicrobial Agents ◽

Multidrug Resistant ◽

Hospitalized Patients ◽

Clinical Samples ◽

Resistance Pattern ◽

Biochemical Tests ◽

Species Specific ◽

High Level ◽

Gelatin Hydrolysis

Staphylococcus aureusis opportunistic human as well as animal pathogen that causes a variety of diseases. A total of 100Staphylococcus aureusisolates were obtained from clinical samples derived from hospitalized patients. The presumptiveStaphylococcus aureusclinical isolates were identified phenotypically by different biochemical tests. Molecular identification was done by PCR using species specific 16S rRNA primer pairs and finally 100 isolates were found to be positive asStaphylococcus aureus. Screened isolates were further analyzed by several microbiological diagnostics tests including gelatin hydrolysis, protease, and lipase tests. It was found that 78%, 81%, and 51% isolates were positive for gelatin hydrolysis, protease, and lipase activities, respectively. Antibiogram analysis of isolatedStaphylococcus aureusstrains with respect to different antimicrobial agents revealed resistance pattern ranging from 57 to 96%. Our study also shows 70% strains to be MRSA, 54.3% as VRSA, and 54.3% as both MRSA and VRSA. All the identified isolates were subjected to detection ofmecA,nuc, andhlbgenes and 70%, 84%, and 40% were found to harbourmecA,nuc, andhlbgenes, respectively. The current investigation is highly important and informative for the high level multidrug resistantStaphylococcus aureusinfections inclusive also of methicillin and vancomycin.

Download Full-text

Vancomycin-Resistant Enterococci and Its Associated Risk Factors among HIV-Positive and -Negative Clients Attending Dessie Referral Hospital, Northeast Ethiopia

International Journal of Microbiology ◽

10.1155/2018/4753460 ◽

2018 ◽

Vol 2018 ◽

pp. 1-9 ◽

Cited By ~ 3

Author(s):

Seid Ali ◽

Martha Alemayehu ◽

Mulat Dagnew ◽

Teklay Gebrecherkos

Keyword(s):

Risk Factors ◽

Multidrug Resistant ◽

Referral Hospital ◽

Health Concern ◽

Diffusion Method ◽

Hiv Positive ◽

Vancomycin Resistant Enterococci ◽

Vancomycin Resistant ◽

Associated Risk Factors ◽

Dessie Referral Hospital

Background. Enterococci are becoming the most important public health concern and emerging as multidrug-resistant organisms around the world including Africa particularly in Ethiopia where there is a lack of availability of effective antimicrobial drugs. However, there is a paucity of data on the prevalence and associated risk factors of vancomycin-resistant enterococci in Ethiopia.Objective. This study was aimed to assess the prevalence of vancomycin-resistant enterococci and its associated risk factors among HIV-positive and -negative clients.Methods. A comparative cross-sectional study was conducted from February to May, 2017, on 300 participants at Dessie Referral Hospital. Data were gathered using a pretested structured questionnaire, stool samples were collected and inoculated on to bile esculin agar, and presumptive colonies were inoculated in brain-heart infusion broth containing 6.5% NaCl for selective identification of enterococci. Antibiotic susceptibility tests were done using the Kirby–Bauer disk diffusion method. Data were analyzed using SPSS version 22 software package.Results. A total of 300 study participants were enrolled in this study, of which 57.7% were females with a mean age of 34.4, a range of 19–73 years. The overall prevalence of enterococci was 37.3%. The prevalence of VRE was 6.3%. From all isolates, the prevalence of VRE among HIV-positive and -negative clients was 5.9% and 7.4%, respectively. Resistance gentamicin, ampicillin, penicillin, and erythromycin was 37.5%, 34.8%, 34.8%, and 22.3%, respectively. Prevalence of multidrug resistance was (29.5%). Being low in hemoglobin content was significantly associated with VRE.Conclusion. The high prevalence of VRE and multidrug-resistant enterococci in this study signals the emergence of VRE. Detection of VRE in this study indicates decreased antibiotic treatment options of multidrug-resistant enterococci. Therefore, there should be a need to perform continuous surveillance, rational use of antibiotics, and more detailed study using phenotypic and genotypic methods.

Download Full-text

Vancomycin-resistant enterococci and coagulase-negative staphylococci prevalence among patients attending at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia

PLoS ONE ◽

10.1371/journal.pone.0249823 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0249823

Author(s):

Degu Ashagrie ◽

Chalachew Genet ◽

Bayeh Abera

Keyword(s):

Venous Blood ◽

Multidrug Resistant ◽

Vancomycin Resistance ◽

World Health ◽

Diffusion Method ◽

P Value ◽

Coagulase Negative Staphylococci ◽

Vancomycin Resistant Enterococci ◽

Specialized Hospital ◽

Vancomycin Resistant

Background Vancomycin resistant enterococci (VRE) and vancomycin resistance coagulase negative staphylococci (VRCoNS) are common pathogens causing difficult to treat health care associated infections (HAI). Hence, the World Health Organization listed VRE as one of the high priority pathogens for new antibiotic discovery and antimicrobial resistance surveillance. Despite this, data on the prevalence of VRE and VRCoNS in Ethiopia is scarce. Thus, the present study determined prevalence of VRE and VRCoNS among patients attending Felege-Hiwot comprehensive specialized hospital, Ethiopia. Methods A hospital based cross-sectional study was conducted on 384 patients selected conveniently from February to March 2020. Data on demographic and clinical variables were collected using a structured questionnaire by face-to-face interview. Simultaneously urine, venous blood and wound swab were collected and processed following standard bacteriological technique. Antimicrobial susceptibility test was performed by minimum inhibitory concentration method using E-test for vancomycin and Kirby-Bauer disc diffusion method for other classes of antibiotics. Data was entered and analyzed using SPSS version 23. Logistic regression was performed to identify factors associated with VRE infection. P. value < 0.05 was considered as statistically significant. Results The prevalence of enterococci and CoNS were 6.8% and 12% respectively. The prevalence of VRE was 34.61% (9/26), while all CoNS (46 isolates) were susceptible to vancomycin. The majority (66.7%) of VRE was isolated from blood samples. Furthermore all VRE (100%), 58.8% of vancomycin susceptible enterococci and 45.7% of CoNS were multidrug resistant (MDR). Having educational level of secondary school and below (AOR = 12.80, CI = 1.149–142.5), previous exposure to catheterization (AOR = 56.0, CI = 4.331–724.0) and previous antibiotic use practice (AOR = 26.25, CI = 3.041–226.2) were a significant associated explanatory factor for VRE infection. Conclusions The prevalence of vancomycin resistance enterococci, which is also multidrug resistant, was significantly high. Though no vancomycin resistance CoNS detected, the MDR level of CoNS was high. Thus to limit enterococci and CoNS infections and MDR development, focused infection prevention measures should be implemented.

Download Full-text

MAGNITUDE OF VANCOMYCIN RESISTANT ENTEROCOCCUS FECAL COLONIZATION AND BACTEREMIA IN PATIENTS WITH HEMATOLOGICAL DISEASES AT TERTIARY BONE MARROW TRANSPLANT CENTRE RAWALPINDI

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i4.4768 ◽

2021 ◽

Vol 71 (4) ◽

pp. 1142-46

Author(s):

Nargis Sabir ◽

Luqman Satti ◽

Abeera Ahmed ◽

Gohar Zaman ◽

Raheel Iftikhar ◽

...

Keyword(s):

Bone Marrow ◽

Bone Marrow Transplant ◽

Armed Forces ◽

Marrow Transplant ◽

Blood Cultures ◽

Diffusion Method ◽

Hematological Diseases ◽

Vancomycin Resistant Enterococci ◽

Transplant Center ◽

Vancomycin Resistant

Objective: To discover the frequency of vancomycin resistant enterococci (VRE) fecal colonization and subsequent bacteremia in patients with hematological diseases in a bone marrow transplant center. Study Design: Cross-sectional study. Place and Duration of Study: Department of Microbiology, Armed Forces Institute of Pathology (AFIP), in collaboration with Armed Forces Bone Marrow Transplant Center, Rawalpindi, from Jan 2016 to Dec 2019. Methodology: Stool specimens/anal swabs from all enrolled patients were collected aseptically and transported to the laboratory without delay. Blood cultures were collected aseptically from only those enrolled patients who developed signs and symptoms of bacteremia. Stool and blood cultures were processed as per standard microbiological protocols. Enterococci were identified to species level by colony morphology and biochemical tests. Modified Kirby Bauer disc diffusion method and VITEK-2 system (Version-8.01 bio Merieux, France) were used to perform antimicrobial sensitivity of each isolate. Results: A total number of 246 patients were studied. Among them, 67 (27%) patients had fecal colonization by vancomycin resistant enterococci. We report a statistically significant association of recent hospitalization, prolonged exposure to antimicrobial therapy, chemotherapy exposure and use of indwelling devices during the hospital stay with vancomycin resistant enterococci colonization. Vancomycin resistant enterococci bacteremia was detected in 57 (23%) patients. Among these 57 patients, 53 (93%) were vancomycin resistant enterococci colonizers. Vancomycin resistant enterococci colonization was significantly associated with vancomycin resistant enterococci bacteremia. Conclusion: A considerable burden of vancomycin resistant enterococci fecal colonization exists among patients with hematological diseases. vancomycin resistant enterococci colonization poses a considerable risk of vancomycin........

Download Full-text

Gastrointestinal tract colonization with vancomycin-resistant Enterococcus faecium in an animal model.

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.40.6.1526 ◽

1996 ◽

Vol 40 (6) ◽

pp. 1526-1530 ◽

Cited By ~ 29

Author(s):

M S Whitman ◽

P G Pitsakis ◽

E DeJesus ◽

A J Osborne ◽

M E Levison ◽

...

Keyword(s):

Animal Model ◽

Gastrointestinal Tract ◽

Enterococcus Faecium ◽

Antimicrobial Agents ◽

Vancomycin Resistant Enterococcus ◽

Vancomycin Resistant Enterococci ◽

Days Of Therapy ◽

Enterococcus Spp ◽

Vancomycin Resistant ◽

Gastrointestinal Colonization

Vancomycin-resistant enterococci have become important nosocomial pathogens in many institutions. The gastrointestinal tract of susceptible hosts serves as the likely reservoir from which the organism is disseminated. To study factors promoting colonization and the efficacy of decontamination therapy with antimicrobial agents, a model of gastrointestinal colonization with vancomycin-resistant Enterococcus faecium was developed in CF1 mice. At baseline, all animals were colonized with non-vancomycin-resistant enterococci (5.0 log10 CFU/g), but vancomycin-resistant organisms were not detectable. Following gastric inoculation with 5 x 10(8) CFU of a clinical isolate of vancomycin-resistant E. faecium, the strain transiently colonized the gastrointestinal tract of 100% of mice but was undetectable by Day 14 (< or = 2.7 log10 mean CFU/g). In animals who received 5 mg of streptomycin per ml or 250 micrograms of vancomycin per ml in drinking water, colonization with the organism occurred at significantly higher bacterial counts than in controls at 7 days following inoculation (9.4 for vancomycin, 9.2 for streptomycin, and 5.1 log10 mean CFU/g for controls; P < 0.05). Fecal concentrations of vancomycin-resistant E. faecium persisted at high counts through Day 22 in mice receiving these antibiotics, but low counts were also still detected in 3 of 10 control animals. In mice with previously established vancomycin-resistant E. faecium colonization, oral administration of ramoplanin, a lipoglycodepsipeptide to which the strain was susceptible, suppressed growth of all enterococci in feces, including the vancomycin-resistant strain after 7 days of therapy (< or = 3.1 and < or = 3.3 log10 mean CFU/g for vancomycin and streptomycin groups, respectively). All mice had a recurrence of colonization with vancomycin-resistant E. faecium after the ramoplanin was discontinued. In summary, this animal model demonstrates the importance of antibiotics in predisposing to gastrointestinal colonization with vancomycin-resistant Enterococcus spp. Although treatment with ramoplanin temporarily suppressed the organism, recurrence of colonization due to relapse or reinfection occurred.

Download Full-text