scholarly journals Increasing proportion of vancomycin resistance among enterococcal bacteraemias in Switzerland: a 6-year nation-wide surveillance, 2013 to 2018

2020 ◽  
Vol 25 (35) ◽  
Author(s):  
Vanja Piezzi ◽  
Michael Gasser ◽  
Andrew Atkinson ◽  
Andreas Kronenberg ◽  
Danielle Vuichard-Gysin ◽  
...  
Keyword(s):  
Multidrug Resistant ◽  
Vancomycin Resistance ◽  
Targeted Prevention ◽  
Prevention Strategies ◽  
Confidential Interval ◽  
Blood Isolate ◽  
Epidemiological Factors ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Using Data

Background Vancomycin-resistant enterococci (VRE), mostly Enterococcus faecium, are multidrug-resistant microorganisms that can cause nosocomial infections. VRE has increased throughout many European countries, but data from Switzerland are scarce. Aim The aim of this work was to characterise the epidemiology of enterococcal bacteraemias in Switzerland with a focus on VRE. Methods In this observational study, we retrospectively investigated bacteraemias from 81 healthcare institutions from January 2013 to December 2018 using data from the Swiss Centre for Antibiotic Resistance. Only the first blood isolate with E. faecalis or E. faecium from an individual patient was considered. We analysed the annual incidences of enterococcal bacteraemias and determined the proportion of VRE over time. We also assessed epidemiological factors potentially associated with VRE bacteraemia. Results We identified 5,369 enterococcal bacteraemias, of which 3,196 (59.5%) were due to E. faecalis and 2,173 (40.5%) to E. faecium. The incidence of enterococcal bacteraemias increased by 3.2% per year (95% confidential interval (CI): 1.6–4.8%), predominantly due to a substantial increase in E. faecalis bacteraemic episodes. Vancomycin resistance affected 30 (1.4%) E. faecium and one E. faecalis bacteraemic episodes. Among all E. faecium bacteraemias, the proportion of vancomycin-resistant isolates increased steadily from 2013 to 2018 (2% per year; 95% CI: 1.5–2.9%). No independent epidemiological factor for higher prevalence of vancomycin-resistant E. faecium bacteraemias was identified. Conclusions Vancomycin-resistant E. faecium bacteraemias remain infrequent in Switzerland. However, an important increase was observed between 2013 and 2018, highlighting the need for implementing active surveillance and targeted prevention strategies in the country.

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

PLoS ONE ◽  
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.

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 Emergence and spread of vancomycin resistance among enterococci in Europe

2008 ◽  
Vol 13 (47) ◽  
Author(s):  
G Werner ◽  
T M Coque ◽  
A M Hammerum ◽  
R Hope ◽  
W Hryniewicz ◽  
...  
Keyword(s):  
Population Analysis ◽  
Vancomycin Resistance ◽  
Vancomycin Resistant Enterococcus ◽  
Phenotypic Marker ◽  
Vancomycin Resistant Enterococci ◽  
Distinct Subpopulation ◽  
Typing Methods ◽  
Vancomycin Resistant ◽  
Hospital Acquired ◽  
Animal Strains

Vancomycin-resistant enterococci (VRE) first appeared in the late 1980s in a few European countries. Nowadays, six types of acquired vancomycin resistance in enterococci are known; however, only VanA and to a lesser extent VanB are widely prevalent. Various genes encode acquired vancomycin resistance and these are typically associated with mobile genetic elements which allow resistance to spread clonally and laterally. The major reservoir of acquired vancomycin resistance is Enterococcus faecium; vancomycin-resistant Enterococcus faecalis are still rare. Population analysis of E. faecium has revealed a distinct subpopulation of hospital-acquired strain types, which can be differentiated by molecular typing methods (MLVA, MLST) from human commensal and animal strains. Hospital-acquired E. faecium have additional genomic content (accessory genome) including several factors known or supposed to be virulence-associated. Acquired ampicillin resistance is a major phenotypic marker of hospital-acquired E. faecium in Europe and experience has shown that it often precedes increasing rates of VRE with a delay of several years. Several factors are known to promote VRE colonisation and transmission; however, despite having populations with similar predispositions and preconditions, rates of VRE vary all over Europe.

scholarly journals High Colonization Rate and Heterogeneity of ESBL- and Carbapenemase-Producing Enterobacteriaceae Isolated from Gull Feces in Lisbon, Portugal

2020 ◽  
Vol 8 (10) ◽  
pp. 1487
Author(s):  
Marta Aires-de-Sousa ◽  
Claudine Fournier ◽  
Elizeth Lopes ◽  
Hermínia de Lencastre ◽  
Patrice Nordmann ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Bacterial Species ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Multidrug Resistant Bacteria ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Encoding Genes

In order to evaluate whether seagulls living on the Lisbon coastline, Portugal, might be colonized and consequently represent potential spreaders of multidrug-resistant bacteria, a total of 88 gull fecal samples were screened for detection of extended-spectrum β-lactamase (ESBL)- or carbapenemase-producing Enterobacteriaceae for methicillin-resistant Staphylococcus aureus (MRSA) and for vancomycin-resistant Enterococci (VRE). A large proportion of samples yielded carbapenemase- or ESBL-producing Enterobacteriaceae (16% and 55%, respectively), while only two MRSA and two VRE were detected. Mating-out assays followed by PCR and whole-plasmid sequencing allowed to identify carbapenemase and ESBL encoding genes. Among 24 carbapenemase-producing isolates, there were mainly Klebsiella pneumoniae (50%) and Escherichia coli (33%). OXA-181 was the most common carbapenemase identified (54%), followed by OXA-48 (25%) and KPC-2 (17%). Ten different ESBLs were found among 62 ESBL-producing isolates, mainly being CTX-M-type enzymes (87%). Co-occurrence in single samples of multiple ESBL- and carbapenemase producers belonging to different bacterial species was observed in some cases. Seagulls constitute an important source for spreading multidrug-resistant bacteria in the environment and their gut microbiota a formidable microenvironment for transfer of resistance genes within bacterial species.

scholarly journals Draft Genome Sequence of a Vancomycin-Resistant and Vancomycin-Dependent Enterococcus faecium Isolate

2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Marion Blaschitz ◽  
Sarah Lepuschitz ◽  
Laura Wagner ◽  
Franz Allerberger ◽  
Alexander Indra ◽  
...  
Keyword(s):  
Genome Sequence ◽  
Enterococcus Faecium ◽  
Prolonged Exposure ◽  
Draft Genome ◽  
Vancomycin Resistance ◽  
Draft Genome Sequence ◽  
Nosocomial Pathogens ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Faecium Isolate

Vancomycin-resistant enterococci have emerged as major nosocomial pathogens worldwide. While antimicrobial pressure promotes nosocomial colonization with these enterococci, prolonged exposure to vancomycin may foster the transition from vancomycin resistance to vancomycin dependence. Here, we report the draft genome sequence of a vancomycin-dependent Enterococcus faecium isolate showing partial teicoplanin dependence.

Enterokokken mit speziellen Resistenzen – Epidemiologie, Hygiene und Therapie

2019 ◽  
Vol 144 (08) ◽  
pp. 553-560 ◽  
Author(s):  
Alexander Mischnik ◽  
Guido Werner ◽  
Jennifer Bender ◽  
Nico Mutters
Keyword(s):  
Scientific Evidence ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Vancomycin Resistant Enterococci ◽  
Resistance Patterns ◽  
Single Intervention ◽  
Vancomycin Resistant ◽  
Meta Analyses ◽  
Resistance Rates ◽  
Insight Into

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.

scholarly journals Differences in Hospital-Associated Multidrug-Resistant Organisms and Clostridium difficile Rates Using 2-Day versus 3-Day Definitions

2014 ◽  
Vol 35 (11) ◽  
pp. 1417-1420 ◽  
Author(s):  
Adrijana Gombosev ◽  
Salah E. Fouad ◽  
Eric Cui ◽  
Chenghua Cao ◽  
Leah Terpstra ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Clostridium Difficile ◽  
Infection Prevention ◽  
Prevention Programs ◽  
Multidrug Resistant ◽  
Infect Control Hosp ◽  
Methicillin Resistant ◽  
Vancomycin Resistant Enterococci ◽  
Multidrug Resistant Organisms ◽  
Vancomycin Resistant

We surveyed infection prevention programs in 16 hospitals for hospital-associated methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci, extended-spectrum β-lactamase, and multidrug-resistant Acinetobacter acquisition, as well as hospital-associated MRSA bacteremia and Clostridium difficile infection based on defining events as occurring >2 days versus >3 days after admission. The former resulted in significantly higher median rates, ranging from 6.76% to 45.07% higherInfect Control Hosp Epidemiol 2014;35(11):1417–1420

scholarly journals Vancomycin Resistance Is Maintained in Enterococci in the Viable but Nonculturable State and after Division Is Resumed

2003 ◽  
Vol 47 (3) ◽  
pp. 1154-1156 ◽  
Author(s):  
Maria del Mar Lleò ◽  
Barbara Bonato ◽  
Caterina Signoretto ◽  
Pietro Canepari
Keyword(s):  
Vancomycin Resistance ◽  
Survival Strategy ◽  
Vbnc State ◽  
Additional Risk ◽  
Viable But Nonculturable ◽  
Vancomycin Resistant Enterococci ◽  
Nonculturable State ◽  
Resistance Trait ◽  
Vancomycin Resistant ◽  
Viable But Nonculturable State

ABSTRACT Stressed vancomycin-resistant enterococci (VRE) can activate a survival strategy known as the viable but nonculturable (VBNC) state and are able to maintain vancomycin resistance. During restoration of division they continue to express the vancomycin resistance trait. We suggest that VBNC enterococci may constitute further reservoirs of VRE and therefore represent an additional risk for human health.

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.

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