scholarly journals Antimicrobial Resistance in Enterococci

2022 ◽  
Vol 66 (9-10) ◽  
pp. 12-16
Author(s):  
N. E. Barantsevich ◽  
S. V. Volkova ◽  
A. Yu. Zaritsky ◽  
E. P. Barantsevich
Keyword(s):  
Antimicrobial Resistance ◽  
Medical Center ◽  
Bloodstream Infections ◽  
Blood Stream ◽  
Multidrug Resistant ◽  
Vancomycin Resistance ◽  
Hospitalized Patients ◽  
Linezolid Resistance ◽  
Enterococcus Spp ◽  
Major Medical Center

Background. Enterococcus spp. are opportunistic agents of community-acquired and in-hospital infections, which have been considered a threat to public health due to their antimicrobial resistance, primarily to glycopeptides, in recent years.The aim of the study is to determine the prevalence of various Enterococcus species causing infections in hospitalized patients and their antimicrobial resistance.Methods included identification by MALDI-TOF mass spectrometry and antimicrobial susceptibility testing in accordance with the EUCAST or, in their absence, CLSI guidelines.Results. Antimicrobial resistance in 1562 consecutive Enterococcus strains isolated from hospitalized patients was determined in a major medical center admitting patients from various regions of the Russian Federation in 2019. The predominance of E.faecalis and E.faecium (99.5%) was revealed; the frequency of isolation of the former was 56% higher than that of the latter. E.avium, E.casseliflavus, E.gallinarum, E.durans were isolated from 0.5% of biological samples. The highest level of resistance of enterococci was observed to erythromycin (84.8%), tetracycline (75.0%), and rifampicin (68.2%). Multidrug, as well as vancomycin resistance, prevailed in E.faecium. All E.faecium strains isolated from blood were multidrug resistant. Resistance to vancomycin in enterococci, causing bloodstream infections, was observed solely in 19.5% of E.faecium; all vancomycin-resistant isolates were also resistant to teicoplanin. Linezolid resistance was detected in 2 community-acquired strains of E.faecalis (0.1%). Rare enterococci have shown diverse patterns of antimicrobial resistance.Conclusions. E.faecalis and E.faecium prevailed among Enterococcus spp. causing infections in hospitalized patients. Multidrug resistance and vancomycin resistance were observed predominantly in E.faecium, especially in strains causing blood-stream infections. Further monitoring of the spread and antimicrobial resistance of various Enterococcus spp. in hospital and community-acquired infections is needed.

scholarly journals Rethinking Manure Application: Increase in Multidrug-Resistant Enterococcus spp. in Agricultural Soil Following Chicken Litter Application

2021 ◽  
Vol 9 (5) ◽  
pp. 885
Author(s):  
Dorcas Oladayo Fatoba ◽  
Akebe Luther King Abia ◽  
Daniel G. Amoako ◽  
Sabiha Y. Essack
Keyword(s):  
Antimicrobial Resistance ◽  
Agricultural Soil ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Resistant Bacteria ◽  
Manure Application ◽  
Unamended Soil ◽  
Enterococcus Spp ◽  
Chicken Litter ◽  
Amended Soil

The current study investigated the impact of chicken litter application on the abundance of multidrug-resistant Enterococcus spp. in agricultural soil. Soil samples were collected from five different strategic places on a sugarcane farm before and after manure application for four months. Chicken litter samples were also collected. Enterococci were enumerated using the Enterolert®/Quanti-Tray 2000® system and confirm and differentiated into species using real-time PCR. The antibiotic susceptibility profile of the isolates was determined using the disk diffusion method following the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines. The overall mean bacterial count was significantly higher (p < 0.05) in manure-amended soil (3.87 × 107 MPN/g) than unamended soil (2.89 × 107 MPN/g). Eight hundred and thirty-five enterococci (680 from soil and 155 from litter) were isolated, with E. casseliflavus being the most prevalent species (469; 56.2%) and E. gallinarum being the least (16; 1.2%). Approximately 56% of all the isolates were resistant to at least one antibiotic tested, with the highest resistance observed against tetracycline (33%) and the lowest against chloramphenicol (0.1%); 17% of E. faecium were resistant to quinupristin-dalfopristin. Additionally, 27.9% (130/466) of the isolates were multidrug-resistant, with litter-amended soil harbouring more multidrug-resistant (MDR) isolates (67.7%; 88/130) than unamended soil (10.0%; 13/130). All isolates were susceptible to tigecycline, linezolid and gentamicin. About 7% of the isolates had a multiple antimicrobial resistance index > 0.2, indicative of high antibiotic exposure. Although organic fertilizers are regarded as eco-friendly compared to chemical fertilizers for improving soil fertility, the application of untreated animal manure could promote the accumulation of antibiotics and their residues and antibiotic-resistant bacteria in the soil, creating an environmental reservoir of antimicrobial resistance, with potential human and environmental health risks.

scholarly journals First Case of Staphylococci Carrying Linezolid Resistance Genes from Laryngological Infections in Poland

Pathogens ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 335
Author(s):  
Michał Michalik ◽  
Maja Kosecka-Strojek ◽  
Mariola Wolska ◽  
Alfred Samet ◽  
Adrianna Podbielska-Kubera ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Resistance Genes ◽  
Ribosomal Proteins ◽  
Multidrug Resistant ◽  
Aureus Strain ◽  
Coagulase Negative Staphylococci ◽  
Spa Typing ◽  
Linezolid Resistance ◽  
First Case ◽  
Resistance Patterns

Linezolid is currently used to treat infections caused by multidrug-resistant Gram-positive cocci. Both linezolid-resistant S. aureus (LRSA) and coagulase-negative staphylococci (CoNS) strains have been collected worldwide. Two isolates carrying linezolid resistance genes were recovered from laryngological patients and characterized by determining their antimicrobial resistance patterns and using molecular methods such as spa typing, MLST, SCCmec typing, detection of virulence genes and ica operon expression, and analysis of antimicrobial resistance determinants. Both isolates were multidrug resistant, including resistance to methicillin. The S. aureus strain was identified as ST-398/t4474/SCCmec IVe, harboring adhesin, hemolysin genes, and the ica operon. The S. haemolyticus strain was identified as ST-42/mecA-positive and harbored hemolysin genes. Linezolid resistance in S. aureus strain was associated with the mutations in the ribosomal proteins L3 and L4, and in S. haemolyticus, resistance was associated with the presence of cfr gene. Moreover, S. aureus strain harbored optrA and poxtA genes. We identified the first case of staphylococci carrying linezolid resistance genes from patients with chronic sinusitis in Poland. Since both S. aureus and CoNS are the most common etiological factors in laryngological infections, monitoring of such infections combined with surveillance and infection prevention programs is important to decrease the number of linezolid-resistant staphylococcal strains.

scholarly journals Towards a Definition for Health Care–Associated Infection

2018 ◽  
Vol 5 (6) ◽  
Author(s):  
N Deborah Friedman ◽  
Dana Levit ◽  
Eyal Taleb ◽  
Gil Marcus ◽  
Leah Michaeli ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Center ◽  
Bloodstream Infections ◽  
Daily Practice ◽  
Multidrug Resistant ◽  
Duke University ◽  
Health Care Associated Infection ◽  
Management Recommendations ◽  
Epidemiological Characteristics ◽  
Present On Admission

Abstract Background Health care–associated infection (HcAI) is a term frequently used to describe community-onset infections likely to be caused by multidrug-resistant organisms (MDROs). The most frequently used definition was developed at Duke University Medical Center in 2002 (Duke-2002). Although some professional societies have based management recommendations on Duke-2002 (or modifications thereof), neither Duke-2002 nor other variations have had their performance measured. Methods A case–control study was conducted at Assaf Harofeh Medical Center (AHMC) of consecutive adult bloodstream infections (BSIs). A multivariable model was used to develop a prediction score for HcAI, measured by the presence of MDRO infection on admission. The performances of this new score and previously developed definitions at predicting MDRO infection on admission were measured. Results Of the 504 BSI patients enrolled, 315 had a BSI on admission and 189 had a nosocomial BSI. Patients with MDRO-BSI on admission (n = 100) resembled patients with nosocomial infections (n = 189) in terms of epidemiological characteristics, illness acuity, and outcomes more than patients with non-MDRO-BSI on admission (n = 215). The performances of both the newly developed score and the Duke-2002 definition to predict MDRO infection on admission were suboptimal (area under the receiver operating characteric curve, 0.76 and 0.68, respectively). Conclusions Although the term HcAI is frequently used, its definition does not perform well at predicting MDRO infection present on admission to the hospital. A validated score that calculates the risk of MDRO infection on admission is still needed to guide daily practice and improve patient outcomes.

scholarly journals Analysis of Antibiotic Resistance Genes in Multidrug-Resistant Acinetobacter sp. Isolates from Military and Civilian Patients Treated at the Walter Reed Army Medical Center

2006 ◽  
Vol 50 (12) ◽  
pp. 4114-4123 ◽  
Author(s):  
Kristine M. Hujer ◽  
Andrea M. Hujer ◽  
Edward A. Hulten ◽  
Saralee Bajaksouzian ◽  
Jennifer M. Adams ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Resistance Genes ◽  
Medical Center ◽  
Antibiotic Resistance Genes ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Walter Reed Army Medical ◽  
Army Medical ◽  
Starting Point ◽  
The Impact

ABSTRACT Military medical facilities treating patients injured in Iraq and Afghanistan have identified a large number of multidrug-resistant (MDR) Acinetobacter baumannii isolates. In order to anticipate the impact of these pathogens on patient care, we analyzed the antibiotic resistance genes responsible for the MDR phenotype in Acinetobacter sp. isolates collected from patients at the Walter Reed Army Medical Center (WRAMC). Susceptibility testing, PCR amplification of the genetic determinants of resistance, and clonality were determined. Seventy-five unique patient isolates were included in this study: 53% were from bloodstream infections, 89% were resistant to at least three classes of antibiotics, and 15% were resistant to all nine antibiotics tested. Thirty-seven percent of the isolates were recovered from patients nosocomially infected or colonized at the WRAMC. Sixteen unique resistance genes or gene families and four mobile genetic elements were detected. In addition, this is the first report of bla OXA-58-like and bla PER-like genes in the U.S. MDR A. baumannii isolates with at least eight identified resistance determinants were recovered from 49 of the 75 patients. Molecular typing revealed multiple clones, with eight major clonal types being nosocomially acquired and with more than 60% of the isolates being related to three pan-European types. This report gives a “snapshot” of the complex genetic background responsible for antimicrobial resistance in Acinetobacter spp. from the WRAMC. Identifying genes associated with the MDR phenotype and defining patterns of transmission serve as a starting point for devising strategies to limit the clinical impact of these serious infections.

scholarly journals Coagulase-negative staphylococcal bloodstream and prosthetic-device-associated infections: the role of biofilm formation and distribution of adhesin and toxin genes

2014 ◽  
Vol 63 (11) ◽  
pp. 1500-1508 ◽  
Author(s):  
Nikolaos Giormezis ◽  
Fevronia Kolonitsiou ◽  
Antigoni Foka ◽  
Eleanna Drougka ◽  
Apostolos Liakopoulos ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Antimicrobial Susceptibility ◽  
Multilocus Sequence Typing ◽  
Biofilm Formation ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Prosthetic Device ◽  
Coagulase Negative Staphylococci ◽  
Toxin Genes ◽  
High Level

Coagulase-negative staphylococci (CNS), especially Staphylococcus epidermidis and Staphylococcus haemolyticus, have emerged as opportunistic pathogens in immunocompromised patients and those with indwelling medical devices. In this study, CNS recovered from patients with bloodstream infections (BSIs) or prosthetic-device-associated infections (PDAIs) were compared in terms of biofilm formation, antimicrobial resistance, clonal distribution, and carriage of adhesin and toxin genes. A total of 226 CNS isolates (168 S. epidermidis and 58 S. haemolyticus) recovered from hospital inpatients with BSIs (100 isolates) or PDAIs (126 isolates) were tested for biofilm formation, antimicrobial susceptibility, and mecA, ica operon, adhesin (aap, bap, fnbA, atlE, fbe) and toxin (tst, sea, sec) genes. The selected CNS were classified into pulsotypes by PFGE and assigned to sequence types by multilocus sequence typing. In total, 106/226 isolates (46.9 %) produced biofilm, whereas 150 (66.4 %) carried the ica operon. Most isolates carried mecA and were multidrug resistant (90.7 %). CNS recovered from BSIs were significantly more likely to produce biofilm (P = 0.003), be resistant to antimicrobials and carry mecA (P<0.001), as compared with isolates derived from PDAIs. CNS from PDAIs were more likely to carry the aap and bap genes (P = 0.006 and P = 0.045, respectively). No significant differences in the carriage of toxin genes were identified (P>0.05). Although PFGE revealed genetic diversity, especially among S. epidermidis, analysis of representative strains from the main PFGE types by multilocus sequence typing revealed three major clones (ST2, ST5 and ST16). A clonal relationship was found with respect to antimicrobial susceptibility and ica and aap gene carriage, reinforcing the premise of clonal expansion in hospital settings. The results of this study suggest that the pathogenesis of BSIs is associated with biofilm formation and high-level antimicrobial resistance, whereas PDAIs are related to the adhesion capabilities of S. epidermidis and S. haemolyticus strains.

scholarly journals Bloodstream infections caused by ST2 Acinetobacter baumannii : Risk factors, antibiotic regimens, and virulence over 6 years period in China

2020 ◽  
Author(s):  
Kaihang Yu ◽  
Weiliang Zeng ◽  
Ye Xu ◽  
Wenli Liao ◽  
Wenya Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acinetobacter Baumannii ◽  
Bloodstream Infection ◽  
Bloodstream Infections ◽  
Tertiary Hospital ◽  
Multidrug Resistant ◽  
High Serum ◽  
Hospitalized Patients ◽  
Effective Treatment Option ◽  
Difficult Challenge

Abstract Background: Bloodstream infection (BSI) caused by multidrug-resistant Acinetobacter baumannii (MDR-AB) has been increasingly observed among hospitalized patients. The following study analyzed the epidemiology and microbiological characteristics of MDR-AB, as well as the clinical features, antimicrobial treatments, and outcomes in patients over a six years period in ChinaMethods: This retrospective study was conducted in a large tertiary hospital in China between January 2013 and December 2018. The clinical and microbiological data of all consecutive hospitalized patients with MDR-AB induced bloodstream infection were included and analyzed. Results: A total of 108 BSI episodes were analyzed. All MDR isolates belonged to ST2, a sequence type that has spread all over the world. Overall, ST2 strains showed strong biofilm formation ability, high serum resistance, and high pathogenicity. As for the clinical characteristics of the patient, 30-day mortality was 69.4% (75/108). The three main risk factors included mechanical ventilation, intensive care unit (ICU) stay, and thrombocytopenia; three protective factors included a change of antimicrobial regimen within 48 h after positive blood culture, use of the antibacterial agent combination, and more inpatient days. The most effective antibacterial regimen was the combination of cefoperazone/sulbactam and tigecycline.Conclusions: BSI caused by ST2 A.baumannii represents a difficult challenge for physicians, considering the high mortality associated with this infection. The combination of cefoperazone/sulbactam and tigecycline may be an effective treatment option.

scholarly journals Three-year study of health care-associated infections in a Turkish pediatric ward

2014 ◽  
Vol 8 (11) ◽  
pp. 1415-1420 ◽  
Author(s):  
Canan Kuzdan ◽  
Ahmet Soysal ◽  
Gulcan Çulha ◽  
Gulsen Altinkanat ◽  
Guner Soyletir ◽  
...  
Keyword(s):  
Health Care ◽  
Bloodstream Infections ◽  
Blood Stream ◽  
Hospitalized Patients ◽  
University Hospital ◽  
Pediatric Ward ◽  
Control Programmes ◽  
Resistance Patterns ◽  
Health Care Associated Infections ◽  
Tract Infections

Introduction: Health care-associated infections (HCAIs) can cause an increase in morbidity, mortality and costs, especially in developing countries. As information on the epidemiology of HCAIs in pediatric patientsinTurkey is limited, we decided to study the annual incidence and antibiotic resistance patterns in our pediatric ward at Marmara University Hospital. Methodology: All hospitalized patients in the pediatric ward were assessed with regard to HCAIs betweenJanuary 1, 2008 and December 31, 2010. Data was prospectively collected according to standard protocols of the National Nosocomial Infections Surveillance System (NosoLINE). Results: A total of 16.5% of all hospitalized patients developed HCAIs in the three years studied. The most frequent HCAIs were urinary tract infections (UTI) (29.3%), bloodstream infections (27%) and pneumonias (21%). While the most frequent agent isolatedfrom UTI was Escherichia coli (26%), the most common agent in blood stream infections was Staphylococcus epidermidis (30.4%). Vancomycin resistance was found in 73.3% of all Enterococcus faecium strains. Extended-spectrum β-lactamase was detected in 58.3% of Klebsiella pneumoniae and E. coli isolates. Conclusions: Continual HCAI surveillance is important to determineits rate. Knowledge of the HCAI incidence can influence people’s use of broad-spectrum antibiotics and encourage antibiotic rotation. Moreover, the knowledge of HCAI incidence may support the infection control programmes, including education and isolation methods which ultimately may help to reducethe rate of the HCAIs.

scholarly journals Antimicrobial Resistance Phenotypic Profile of Isolates from Clinical Infections in Dogs

2017 ◽  
Vol 45 (1) ◽  
pp. 8
Author(s):  
Ricardo Antonio Pilegi Sfaciotte ◽  
Lincoln Garcia Coronel ◽  
Alessandra Snak ◽  
Jéssica Tainá Bordin ◽  
Paula Wildemann ◽  
...  
Keyword(s):  
Veterinary Medicine ◽  
Antimicrobial Resistance ◽  
Antimicrobial Agent ◽  
Companion Animals ◽  
Multidrug Resistant ◽  
Cross Resistance ◽  
Resistant Bacteria ◽  
Gram Positive ◽  
Enterococcus Spp ◽  
Staphylococcus Spp

Background: Antimicrobial resistance is described as a condition in which a micro-organism is able to survive when exposed to an antimicrobial agent. The resistance rates to antimicrobials in companion animals have risen considerably. Studies of local antimicrobial susceptibility profiles are needed as well as education and warning about the use of tests for the identification and susceptibility of pathogenic bacterial strains. The aim of this study was to identify the main antimicrobial resistance in clinical samples of dogs, and to detect multidrug-resistant strains of importance to public health.Materials, Methods & Results: Bacterial pathogens of 77 dog infections were isolated and their sensitivity profile to antimicrobials was determined. One hundred bacterial isolates were identified. Of these, 61 were Gram-positive (55 Staphylococcus spp., 4 Enterococcus spp. and 2 Streptococcus spp.) and 39 Gram-negative (36 fermenters and 3 non-fermenters). Seventy-nine isolates were considered multiresistant following individual assessment of drugs, and 85 following the evaluation of classes. Only 3 were sensitive to all drugs. Four isolates were resistant to all classes and only sensitive to some antibiotics. Of the 55 samples of Staphylococcus spp., 36 (65.45%) were identified as phenotypically MRS. Two isolates of Enterococcus spp. were resistant to vancomycin (VRE). Also 66.67% (26/39) of the samples were positive for the presumptive test for ESBL. For the MRS-positive isolates detected in this study, chloramphenicol was the antimicrobial that showed superior sensitivity in 74.29% of the cases (27/36); therefore it is considered the most appropriate for treatment of this type of micro-organism. In case of aminoglycosides, when their resistance was checked in MRS isolates, all resistance percentages increased, implying a limited use of this class for such a type of multi-resistant micro-organism. Contrarily, in case of ESBL, a superior sensitivity was observed towards MRS isolates, thus making them a prime treatment choice for the infection caused by these micro-organisms.Discussion: Literature have reported a gradual increase in multidrug resistance towards antimicrobial agents in veterinary medicine over the past decades. In this study, 64% of multiresistant strains were considered of significant importance, notably MRS (36), VRE (2) and ESBL (26). The early identification of pathogens in animals has become an important step in order to minimize the transmission of antibacterial resistance. The increase in the number of multidrug-resistant bacteria in animals and humans demonstrates the need to develop and implement measures in order to monitor and control the spread of this resistance. It is possible that the increased drug resistance is linked to the constant exposure to these drugs and the subsequent selective pressure, causing the transfer of resistant genes between strains. Carbapenems and glycopeptides should be used with caution in veterinary medicine in order to prevent such processes of selection that develop resistance in micro-organisms to these two classes, which can result in cross-resistance between animals and humans and create obstacles in the treatment of patients, especially for the two drugs mentioned, since they are important for the treatment of nosocomial infections in humans. The resistance percentage towards fluoroquinolones was identified to be higher in Gram-positive isolates, particularly in MRS, which showed 75% resistance against this class (according to the CLSI, resistance to one fluoroquinolone antimicrobial agent provides resistance to other antimicrobials of this class). For ESBL isolates, the resistance was shown to be 50%. The resistance towards the fluoroquinolones and aminoglycosides class can be associated with the expression of the genes that produce ESBL.

scholarly journals Attributable Costs of Enterococcal Bloodstream Infections in a Nonsurgical Hospital Cohort

2010 ◽  
Vol 31 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Anne M. Butler ◽  
Margaret A. Olsen ◽  
Liana R. Merz ◽  
Rebecca M. Guth ◽  
Keith F. Woeltje ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Propensity Score ◽  
Medical Center ◽  
Academic Medical Center ◽  
Hospital Costs ◽  
Bloodstream Infections ◽  
Generalized Least Squares ◽  
Vancomycin Resistance ◽  
Independent Effect ◽  
Matched Pairs

Background.Vancomycin-resistantEnterococcus(VRE) bloodstream infections (BSIs) are associated with increased morbidity and mortality.Objective.To determine the hospital costs and length of stay attributable to VRE BSI and vancomycin-sensitiveEnterococcus(VSE) BSI and the independent effect of vancomycin resistance on hospital costs.Methods.A retrospective cohort study was conducted of 21,154 nonsurgical patients admitted to an academic medical center during the period from 2002 through 2003. Using administrative data, attributable hospital costs (adjusted for inflation to 2007 US dollars) and length of stay were estimated with multivariate generalized least-squares (GLS) models and propensity score-matched pairs.Results.The cohort included 94 patients with VRE BSI and 182 patients with VSE BSI. After adjustment for demographics, comorbidities, procedures, nonenterococcal BSI, and early mortality, the costs attributable to VRE BSI were $4,479 (95% confidence interval [CI], $3,500-$5,732) in the standard GLS model and $4,036 (95% CI, $3,170-$5,140) in the propensity score-weighted GLS model, and the costs attributable to VSE BSI were $2,250 (95% CI, $l,758-$2,880) in the standard GLS model and $2,023 (95% CI, $1,588-$2,575) in the propensity score-weighted GLS model. The median values of the difference in costs between matched pairs were $9,949 (95% CI, $1,579-$24,693) for VRE BSI and $5,282 (95% CI, $2,042-$8,043) for VSE BSI. The costs attributable to vancomycin resistance were $1,713 (95% CI, $1,338-$2,192) in the standard GLS model and $1,546 (95% CI, $1,214-$1,968) in the propensity score-weighted GLS model. Depending on the statistical method used, attributable length of stay estimates ranged from 2.2 to 3.5 days for patients with VRE BSI and from 1.1 to 2.2 days for patients with VSE BSI.Conclusions.VRE BSI and VSE BSI were independently associated with increased hospital costs and increased length of stay. Vancomycin resistance was associated with increased costs.

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.

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