DETECTION AND CHARACTERISATION OF VANCOMYCIN RESISTANT ENTEROCOCCAL ISOLATES OF CLINICAL SAMPLES FROM A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 76-79
Author(s):  
R.Beaula Lilly ◽  
V.K.M. Banu
Keyword(s):  
Multiple Drug Resistance ◽  
Tertiary Care ◽  
Vancomycin Resistance ◽  
Therapeutic Options ◽  
Hospital Environment ◽  
Clinical Samples ◽  
Multiple Drug ◽  
Care Hospital ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant

The emergence of Vancomycin resistant enterococci (VRE) has posed serious threats to the community because they exhibit multiple drug resistance, thus limiting the therapeutic options for the clinicians. As Vancomycin resistant enterococci (VRE) also have ampicillin resistance and high level aminoglycoside resistance, they are the most difcult to treat. The therapeutic options are limited by elimination of the synergy between aminoglycoside and the beta lactum drugs which is the treatment of choice for enterococcal infections which is of great concern. More antibiotic resistance makes these pathogens excellent survivors in hospital environment and cause nosocomial infections. Atotal of 142 enterococcal isolates from various clinical samples were identied to their species level and subjected to antimicrobial susceptibility testing to various antibiotics. Initial screening for Vancomycin resistance was done using the Vancomycin Screen Agar and the isolates showing resistance were subjected to Vancomycin and Teicoplanin MIC and later these isolates showing resistance were conrmed by genotypic methods for Vancomycin resistant genes.Total VRE isolates as per Vancomycin MIC value were 19 and the prevalence rate was 13.3% (19/142).In PCR assay, a total of 16 isolates including 13 E.faecium and 3 E.faecalis were found to be of Van B genotype and the remaining 3 isolates including 2 E.faecium and 1 E.faecalis were found to be of Van A genotype. In this study, the prevalence of Vancomycin resistance in Enterococcal species is 13.3% as per vancomycin MIC by Micro broth dilution technique. The phenotypic detection of Vancomycin resistance by MIC of Vancomycin and Teicoplanin correlates with the genotypic method of detection of Vancomycin resistant genes (VanA, VanB).

scholarly journals A study on virulence factors and antimicrobial resistance pattern among enterococci isolated from various clinical specimens from a tertiary care hospital

2017 ◽  
Vol 5 (7) ◽  
pp. 2969
Author(s):  
Hemalatha G. ◽  
Bhaskaran K. ◽  
Sowmiya M. ◽  
Anusheela Howlader ◽  
Sethumadhavan K.
Keyword(s):  
Antimicrobial Resistance ◽  
Virulence Factors ◽  
Tertiary Care ◽  
Vancomycin Resistance ◽  
Control Measures ◽  
Hospital Environment ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Drain Tube ◽  
Care Hospital

Background: Enterococci, adult faeces commensal are important nosocomial pathogens. E. faecalis is the most common cause of infection, followed by E. faecium. In the past two decades, they have developed resistance to many commonly used antimicrobial agents. Understanding virulence factors and monitoring antimicrobial resistance among Enterococci is essential for controlling the spread of bacterial resistance and important for epidemiological surveillance within the hospital environment. The aim of the study is to evaluate antibiotic resistance and virulence factors exhibited by Enterococcus sp.Methods: One hundred consecutive isolates of Enterococci isolated from different clinical samples of patients attending AVMC and H, a tertiary care center at Pondicherry in a period of 20 months were included in the study. Enterococcus sp were identified as per standard conventional bacteriologic methods and detected for the production of virulence factors such as Hemolysin production, Gelatinase production. Antimicrobial susceptibility testing was carried out by disc diffusion method and MIC of vancomycin and teicoplanin was determined by E-test strips.Results: Among 100 Enterococcal isolates included in the study, 81% were E. faecalis and 19% were E. faecium which were isolated from urine (44%), Pus (51%) and others specimen (5%, which includes blood 80% and drain tube 20%). In this study, overall 15% of E. faecalis and 1% of E. faecium showed hemolysin production and Gelatinase was produced by 6% of E. faecalis and 4% of E. faecium. Majority of E. faecalis and E. faecium strains isolated in our study, had increased sensitivity were to be exhibited for Linezolid, Vancomycin followed by high level gentamycin and high degree of resistance to penicillin, ciprofloxacin and cotrimoxazole. Analyzing the results of MIC of vancomycin and teicoplanin, 5 isolates were classified phenotypically as VanB phenotype that possess only moderate to high levels of vancomycin resistance and one isolate obtained from drain tube which showed MIC of vancomycin as 120µg/ml and teicoplanin 16µg/ml was grouped into VanA.Conclusions: Though the prevalence of vancomycin resistant Enterococcci (VRE) is very low in our study, yet regular monitoring of vancomycin resistance is very crucial for early detection, treatment, application of preventive and control measures and most importantly to check the spread of virulent multidrug resistant Enterococcus species.

scholarly journals Prevalence of vancomycin resistance and multiple drug resistance in enterococci in equids in North India

2009 ◽  
Vol 3 (07) ◽  
pp. 498-503 ◽  
Author(s):  
Bhoj Raj Singh
Keyword(s):  
Multiple Drug Resistance ◽  
Tertiary Care ◽  
Vancomycin Resistance ◽  
North India ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Multiple Drug ◽  
Drug Resistant ◽  
Emerging Pathogens ◽  
Multiple Drugs

Introduction: Vancomycin resistant and multi-drug-resistant enterococci are the major emerging pathogens in surgical, neonatal, and tertiary care units. Methodology: In this study, 267 enterococci from different clinical and non-clinical samples of equine origin were tested for their antimicrobial drug sensitivity against 19 antimicrobials using disc diffusion method. Results: A total of 80.2% enterococci tested were resistant to vancomycin and 99.6% to multiple-drugs. There was a significant association between haemolytic potential and vancomycin resistance (χ2, 0.00). Enterococci isolates from healthy equids were significantly (χ2, 0.04) less resistant to vancomycin than the isolates from clinically sick animals. Besides vancomycin sensitivity, isolates were also tested for 18 more antimicrobial drugs; maximum numbers of isolates were sensitive to imipenem (75%) followed by tetracycline (60%), amoxicillin+clavulanic acid (54%), and minimum for cefdinir (4%). Conclusion: More than 80% strains of enterococci of equine origin were found resistant to vancomycin and 99.6% were multiple-drug resistant in Northern India. High prevalence of VRE and MDRE in healthy equids might be a potential danger for the health of persons in equine contact.

scholarly journals Comparison of Different Phenotypic Methods for Detection of Vancomycin Drug Resistance in Enterococcus Species

2021 ◽  
Vol 8 (9) ◽  
pp. 289-293
Author(s):  
Deepa Pramod Devhare ◽  
Sae Pol
Keyword(s):  
Drug Resistance ◽  
Tertiary Care ◽  
Vancomycin Resistance ◽  
Automated System ◽  
Disk Diffusion ◽  
Clinical Samples ◽  
Care Hospital ◽  
Enterococcus Species ◽  
Vancomycin Resistant ◽  
Phenotypic Methods

Introduction: Vancomycin resistant enterococci have emerged as an important cause of nosocomial infection worldwide. Vancomycin drug resistance needs to be detected accurately in all Enterococcus species in order to prevent its spread in health care setting. Present study was conducted to compare three different phenotypic methods for detection of vancomycin resistance in enterococci. Material and methods: Study was conducted in a tertiary care hospital over a period of one year. Enterococcus species isolated from clinical samples like urine, pus, blood and sterile body fluids were tested by three different methods namely disk diffusion, E-strip and Phoenix automated system for detection of vancomycin resistance. Results: 400 Enterococcus species were isolated from clinical samples. 19(4.8%) Enterococcus species were found to be vancomycin resistant and one (0.25%) strain was found to be intermediate resistant to vancomycin by all three methods resulting in 100% sensitivity and 100%specificity. Conclusion: Present study recommends vancomycin disk diffusion as screening and E-strip as good confirmatory tests in resource poor settings for detection of vancomycin drug resistance. Keywords: VRE, vancomycin, disk diffusion, E strip, Phoenix automated system..

scholarly journals First detection of vanB phenotype-vanA genotype vancomycin-resistant enterococci in Egypt

2019 ◽  
Vol 13 (09) ◽  
pp. 837-842 ◽  
Author(s):  
Rasha MM Khairy ◽  
Mahmoud Shokry Mahmoud ◽  
Mona Abdel Monem Esmail ◽  
Aya Nabil Gamil
Keyword(s):  
Real Time ◽  
Real Time Pcr ◽  
Multiple Drug Resistance ◽  
Vancomycin Resistance ◽  
Hospital Environment ◽  
Dilution Method ◽  
Multiple Drug ◽  
Agar Dilution Method ◽  
Vancomycin Resistant ◽  
Hospital Acquired

Introduction: Enterococci have emerged in last two decades as serious hospital acquired pathogens particularly vancomycin resistant strains (VRE). The study aimed to identify the prevalence of enterococcal isolation from hospital infections and colonization as well as determine vancomycin resistance phenotypes and genotypes. Methods: Sixty enterococcus isolates were isolated from patients, health care workers and hospital environment, identified and tested for antimicrobial susceptibility. Enterococcus species were identified by Real-time PCR and vancomycin resistance was assessed by agar dilution method and Real-time PCR. Results; out of 300 samples (20%) were enterococci (53.3% were E. faecium, 31.7% E. faecalis and 10% other enterococci). Among of them 40/60 (66, 6%) were isolated from infections and 33.3% were isolated from colonization. multiple drug resistance was reported in (100%) of isolates, while (95%) and (45%) of isolates were resistant to vancomycin and ticoplanin respectively. VanA phenotype, vanA genotype was identified in (47.4%) of isolates, while vanB phenotype, vanA genotype was identified in (33.3%) of vancomycin resistant isolates. Conclusion; VanB phenotype-vanA genotype was identified in (33.3%) of vancomycin resistant enterococcal isolates. To our knowledge it is the first identified incidence of such strains in Egypt and Africa.

Prevalence of Vancomycin Resistant Enterococci in Various Clinical Specimens in Tertiary Care Hospital in North Delhi

2012 ◽  
Vol 3 (3) ◽  
pp. 141-144
Author(s):  
Swati Chaudhary ◽  
◽  
Swastika Aggarwal ◽  
Pawan Kumar ◽  
SK Aggarwal SK Aggarwal ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Clinical Specimens ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant

scholarly journals A Japanese traditional medicine Hochuekkito promotes negative conversion of vancomycin-resistant Enterococci

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Junko Kohno ◽  
Tsuyoshi Kawamura ◽  
Akiko Kikuchi ◽  
Tetsuya Akaishi ◽  
Shin Takayama ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Tertiary Care ◽  
Albumin Level ◽  
Kampo Medicine ◽  
Care Hospital ◽  
Intestinal Immunity ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Japanese Traditional Medicine ◽  
Negative Conversion

AbstractVancomycin-resistant enterococci (VRE) are prominent causes of nosocomial infections. Japanese traditional (Kampo) medicine promotes intestinal immunity and protects against bacterial infections. We assessed potential differences in the clinical course of VRE-positive patients, based on their characteristics and treatment with Kampo medicines. This retrospective observational study collected data from VRE-positive patients from August 2018 to July 2019 at a tertiary-care hospital in Japan. The data of 122 consecutive VRE-positive inpatients were analyzed. Sixty-nine patients were treated with probiotics, among whom, 18 were further treated with Kampo medicines. Twenty-six of the 122 patients subsequently died. In univariate analyses, subsequent VRE negative conversion significantly reduced the mortality of VRE-detected patients (p = .0003). Administration of probiotics (p = .0065) and Kampo medicines with probiotics (p = .0002), especially of the Kampo medicine hochuekkito (p = .0014), and a higher serum albumin level positively contributed to the subsequent VRE negative conversion. Multivariate analyses demonstrated that Kampo medicines and body mass index contributed to VRE negative conversion. Hochuekkito shortened the time needed for VRE negative conversion (p = 0.0485). Administration of Kampo medicines, especially of hochuekkito, in addition to probiotics in VRE patients may promote VRE negative conversion.

scholarly journals TO STUDY ANTIBIOTIC SENSITIVITY PATTERN OF NONFERMENTATIVE GRAM NEGATIVE BACILLI FROM VARIOUS CLINICAL SAMPLES IN A TERTIARY CARE HOSPITAL, JAIPUR.

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Kirti Hemwani ◽  
P. S. Nirwan ◽  
Preeti Shrivastava ◽  
Abhiraj Ramchandani
Keyword(s):  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Polymyxin B ◽  
Hospital Environment ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital ◽  
Pathogenic Potential ◽  
Gram Negative ◽  
Sensitivity Pattern

Background: Nonfermentative gram negative bacilli (NFGNB) frequently considered as commensals or contaminants but the pathogenic potential of nonfermenters has been proved beyond doubt. They are resistant to commonly used antimicrobials. Aim: This study was undertaken to identify the nonfermenters isolated from various clinical samples and to know their Antibiotic sensitivity pattern. Materials and Methods: The present study was carried out on 150 strains of Nonfermenters isolated from 1200 various non repetitive clinical samples received in Department of Microbiology, NIMS Jaipur. Nonfermenters were identified using a standard protocol and their antibiotic susceptibility testing was performed with the help of the modified Bauer disc diffusion method. Results: Out of 150 nonfermenters isolated, Pseudomonas aeruginosa was the most common isolate 134 (89.33%) followed by Acinetobacter baumannii 16 (10.67%). Among all clinical samples Pus and Wound Discharge yield maximum isolates of NFGNB i.e. 54 (36%) % followed by sputum (39.0%). Most sensitive drug against NFGNB was Polymyxin-B (100%) followed by Imipenem (86 %) and Amikacin (71.33 %). Conclusion: Nonfermenters have a great potential to survive in a hospital environment so implementation of antibiotic stewardship programs and strict infection control practices will be required to prevent or slow down their emergence and spread. Keywords:  Nonfermenters,  Polymyxin-B, Pseudomonas, Acinetobacter.

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.

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