scholarly journals Vancomycin-resistant Enterococcus faecium in Algeria: phenotypic and genotypic characterization of clinical isolates

2021 ◽  
Vol 15 (01) ◽  
pp. 95-101
Author(s):  
Nabila Benamrouche ◽  
Badia Guettou ◽  
Fatma Zohra Henniche ◽  
Farida Assaous ◽  
Houcine Laouar ◽  
...  
Keyword(s):  
Enterococcus Faecium ◽  
Public Health Problem ◽  
Test Method ◽  
Control Measures ◽  
Molecular Characteristics ◽  
Major Public Health Problem ◽  
Vancomycin Resistant Enterococcus ◽  
Infection Control Measures ◽  
Vancomycin Resistant ◽  
High Level

Introduction: vancomycin-resistant Enterococcus faecium (VREfm) is a major public health problem worldwide. The aim of our study was to determine the microbiological, epidemiological and molecular characteristics of VREfm isolated in north-central, eastern and western Algeria. Methodology: a collection of 48 VREfm isolated from September 2010 to April 2017 in several Algerian hospitals were studied. Minimum inhibitory concentrations (MICs) were determined by E-test method according to CLSI guidelines. the detection of van genotype of all strains was performed by PCR. Clonal relationship of five VREfm targeted by region were characterized using multilocus sequence typing (MLST). Results: All isolates have multidrug-resistance (MDR) and were resistant to at least five classes of antibiotics; however, all were susceptible to tigecycline and daptomycin with MIC50 at 0.094 µg/mL and 2 µg/mL respectively. All strains belonged to vanA genotype and have high level of resistance to vancomycin and teicoplanin. MLST revealed two sequence types (STs): ST80 (from the four regions of Algeria) and ST789, both belonging to the former hospital-adapted clonal complex CC17. Conclusions: the alarming dissemination of MDR E. faecium vanA and the ST80 in several regions of Algeria suggest a clonal spread of VREfm strains, which urgently require implementation of adequate infection control measures.

scholarly journals Interhospital Transmission of Vancomycin-resistant Enterococcus Faecium in Aomori, Japan

2021 ◽  
Author(s):  
Norihiro Saito ◽  
Junichi Kitazawa ◽  
Hiroko Horiuchi ◽  
Takeo Yamamoto ◽  
Masahiko Kimura ◽  
...  
Keyword(s):  
Enterococcus Faecium ◽  
Continuous Monitoring ◽  
Clonal Propagation ◽  
Sequence Type ◽  
Control Measures ◽  
Vancomycin Resistant Enterococcus ◽  
Infection Control Measures ◽  
Vancomycin Resistant ◽  
Aomori Prefecture ◽  
Hospital Transmission

Abstract A series of vancomycin-resistant Enterococcus faecium (VREf) outbreaks caused by clonal propagation due to inter-hospital transmission occurred in six general hospitals in Aomori prefecture, Japan. This was the first multi-jurisdictional outbreak of VREf sequence type 1421 in Japan. It took almost three years for VREf prevalence to return to pre-outbreak levels. The duration and size of outbreaks differed between hospitals according to the countermeasures available at each hospital. Prompt and strong countermeasures including patient isolation and repetitive screening of all inpatients were required to control the outbreaks. In addition to strict infection control measures, continuous monitoring of VREf prevalence in local medical regions and smooth and immediate communication among hospitals are required to prevent VREf outbreaks.

scholarly journals 1255. First Outbreak Due to Vancomycin-Resistant Enterococcus Epidemic Clone ST796 in Europe

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S382-S383
Author(s):  
Nasstasja Wassilew ◽  
Eveline Rolli ◽  
Yvonne Fietze ◽  
Carlo Casanova ◽  
Helena Seth-Smith ◽  
...  
Keyword(s):  
Infection Control ◽  
Genome Sequencing ◽  
Enterococcus Faecium ◽  
Control Measures ◽  
University Hospital ◽  
Whole Genome ◽  
Vancomycin Resistant Enterococcus ◽  
Infection Control Measures ◽  
Vancomycin Resistant ◽  
Hospital Group

Abstract Background A large outbreak with different clones of vancomycin-resistant enterococci (VRE) affected the Bern University Hospital group for several months. The aim of this study was to describe the extent of the outbreak, using whole-genome sequencing (WGS). Methods Triggered by two cases of VRE bloodstream infections on our hemato-oncology ward, an outbreak investigation was started. Microbiological diagnosis of VRE was obtained by culture and PCR. Epidemiological links were assessed by meticulous chart review and supplemented with WGS analyses. Multiple infection control measures were implemented to avoid further transmissions. Results Between December 2017 and April 2018, 2,877 screening samples were obtained from 1,200 patients. Three out of six hospitals within the Bern University Hospital group were affected. Eighty-three patients (6.9%) were colonized with VR Enterococcus faecium. Of those, 76 (91.6%) had a strain carrying vanB, with 70 (84%) isolates virtually identical (separated by up to two alleles) by cgMLST and identified as MLST type ST796 (figure). The remaining seven patients (8.4%) were colonized with vanA carrying strains from five different STs. Five patients (7%) developed an invasive infection with VRE ST796. Temporo-spatial links were found in most patients carrying the outbreak strain. In order to control the outbreak, extensive infection control measures were implemented. By April 2018 the outbreak was contained with these specific measures. Conclusion This VRE outbreak was characterized by a rapid intra- and inter-institutional spread of the emergent clone ST796. This clone was recently described in Australia and New Zealand but never before in Europe.1,2 A multi-faceted infection control led to the containment of the outbreak. References 1. Mahony AA, et al. Vancomycin-resistant Enterococcus faecium sequence type 796—rapid international dissemination of a new epidemic clone. Antimicrob Resist Infect Control. 2018:7:44. 2. Leong KWC, et al. Emergence of vancomycin-resistant Enterococcus faecium at an Australian Hospital: a whole genome sequencing analysis. Sci Rep. 2018:8(1):6274. 3. de Been M, et al. Core genome multilocus sequence typing scheme for high- resolution typing of Enterococcus faecium. J Clin Microbiol. 2015:53(12):3788–97. Disclosures All authors: No reported disclosures.

First Outbreak of Colonization and Infection With Vancomycin-ResistantEnterococcus faeciumin a Tertiary Care Hospital in Singapore

2006 ◽  
Vol 27 (9) ◽  
pp. 991-993 ◽  
Author(s):  
Maciej Piotr Chlebicki ◽  
Moi Lin Ling ◽  
Tse Hsien Koh ◽  
Li Yang Hsu ◽  
Ban Hock Tan ◽  
...  
Keyword(s):  
Infection Control ◽  
Enterococcus Faecium ◽  
Public Hospital ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Control Measures ◽  
Care Hospital ◽  
Infection Control Measures ◽  
Vancomycin Resistant

We report the first outbreak of vancomycin-resistantEnterococcus faeciumcolonization and infection among inpatients in the hematology ward of an acute tertiary care public hospital in Singapore. Two cases of bacteremia and 4 cases of gastrointestinal carriage were uncovered before implementation of strict infection control measures resulted in control of the outbreak.

scholarly journals Vancomycin-Resistant Enterococcus faecium: Catheter Colonization, esp Gene, and Decreased Susceptibility to Antibiotics in Biofilm

2005 ◽  
Vol 49 (12) ◽  
pp. 5046-5050 ◽  
Author(s):  
Issam I. Raad ◽  
Hend A. Hanna ◽  
Maha Boktour ◽  
Gassan Chaiban ◽  
Ray Y. Hachem ◽  
...  
Keyword(s):  
Enterococcus Faecium ◽  
Gel Electrophoresis ◽  
Antibiotic Susceptibility ◽  
Pulsed Field Gel Electrophoresis ◽  
Molecular Characteristics ◽  
Vancomycin Resistant Enterococcus ◽  
Catheter Colonization ◽  
Pulsed Field ◽  
Vancomycin Resistant ◽  
Gastrointestinal Colonization

ABSTRACT To evaluate the molecular characteristics and antibiotic susceptibility in biofilm of vancomycin-resistant Enterococcus faecium (VREF) organisms that had caused catheter-related VREF bacteremia (VREF-CRB), we compared 22 isolates causing bacteremia obtained from patients with VREF-CRB with 30 isolates from control patients with gastrointestinal colonization by VREF. Using pulsed-field gel electrophoresis, we identified 17 unique strains among the 22 VREF-CRB isolates and 23 strains among the gastrointestinal isolates. The esp gene was detected in 53% (9 of 17) of the VREF-CRB and 61% (14 of 23) of the control strains (P = 0.6). VREF-CRB produced heavier biofilm colonization of silicone disks than did control organisms (P < 0.001). Daptomycin, minocycline, and quinupristin-dalfopristin were each independently more active than linezolid in reducing biofilm colonization by VREF-CRB (P < 0.01), with daptomycin being the most active, followed by minocycline. In conclusion, the esp gene in VREF is not associated with heavy biofilm colonization or catheter-related bacteremia. In biofilm, daptomycin and minocycline were the most active antibiotics against VREF, and linezolid was the least active.

scholarly journals Genotypic and Phenotypic Evaluation of the Evolution of High-Level Daptomycin Nonsusceptibility in Vancomycin-Resistant Enterococcus faecium

2012 ◽  
Vol 56 (11) ◽  
pp. 6051-6053 ◽  
Author(s):  
Romney M. Humphries ◽  
Theodoros Kelesidis ◽  
Ryan Tewhey ◽  
Warren E. Rose ◽  
Nicholas Schork ◽  
...  
Keyword(s):  
Enterococcus Faecium ◽  
Open Reading Frames ◽  
Vancomycin Resistant Enterococcus ◽  
Single Nucleotide Variants ◽  
Phosphotransferase System ◽  
Single Nucleotide ◽  
Content Type ◽  
Vancomycin Resistant ◽  
High Level ◽  
Reading Frames

ABSTRACTWhole-genome sequencing and cell membrane studies of three clonalEnterococcus faeciumstrains with daptomycin MICs of 4, 32, and 192 μg/ml were performed, revealing nonsynonymous single nucleotide variants in eight open reading frames, including those predicted to encode a phosphoenolpyruvate-dependent, mannose-specific phosphotransferase system, cardiolipin synthetase, and EzrA. Membrane studies revealed a higher net surface charge among the daptomycin-nonsusceptible isolates and increased septum formation in the isolate with a daptomycin MIC of 192 μg/ml.

scholarly journals Vancomycin intermediate and high level vancomycin resistant Staphylococcus aureus clinical isolates in Osogbo, Nigeria

2011 ◽  
Vol 2 (1) ◽  
pp. 6
Author(s):  
Samuel Sunday Taiwo ◽  
Titilope Bosede Bamigboye ◽  
Osatohanmwen Odaro ◽  
Olusegun Adelowo Adefioye ◽  
Solomon Olufemi Fadiora
Keyword(s):  
Staphylococcus Aureus ◽  
Public Health Problem ◽  
Disk Diffusion ◽  
Major Public Health Problem ◽  
Disk Diffusion Test ◽  
Mueller Hinton ◽  
Mueller Hinton Agar ◽  
Vancomycin Resistant ◽  
High Level ◽  
Broth Dilution

<p>The decreased vancomycin susceptibility and subsequent emergence of vancomycin resistant <em>Staphylococcus aureus </em>(VRSA) strains already multi-resistant to antibiotics is a major public health problem. In 2009, the Clinical and Laboratory Standards Institute (CLSI) altered its guidelines for vancomycin susceptibility testing in <em>S. aureus</em> and recent data suggests the possibility that VRSA may emerge more frequently than previously expected. Against this background, we conducted a study to ascertain the susceptibility status of clinical <em>S. aureus</em> isolates to vancomycin in our environment using vancomycin agar screen, disk diffusion and broth dilution methods. Of the total 49 <em>S. aureus </em>invasive strains isolated, 25 (51.0%) had vancomycin MIC of ≤2µg/ml by the CLSI standard broth dilution method and are classed as vancomycin susceptible; 18 (36.7%) had MIC of 4-8µg/ml (vancomycin intermediate resistant) and 6 (12.2%) had MIC of &gt;256µg/ml (high level vancomycin resistant). Vancomycin agar screen with Mueller-Hinton agar containing 3µg/ml vancomycin (MHA-V3) correctly identified 20 of 25 (80%) vancomycin susceptible isolates; detected all 6 vancomycin resistant isolates and 16 of 18 (88.9%) vancomycin intermediate strains. Similarly, Mueller-Hinton agar containing 6µg/ml vancomycin (MHA-V6) correctly identified 23 of 25 (92%) vancomycin susceptible isolates and all 6 vancomycin resistant isolates but detected 14 (77.8%) of 18 vancomycin intermediate strains. Vancomycin disk diffusion test correctly identified all the 25 vancomycin susceptible <em>S. aureus</em> isolates giving 100% specificity but detected only 1 of 18 (5.6%) vancomycin intermediate and none (0%) of vancomycin resistant isolates. This result shows the occurrence of VISA and high level VRSA isolates in our environment, which contrary to current belief, may indicate widespread dissemination of VRSA. MHA-V3 agar is a useful alternative screening medium for vancomycin non-susceptibility detection in clinical <em>S. aureus</em> isolates but vancomycin disk diffusion is not useful in this regard.</p>

scholarly journals Genomic surveillance of vancomycin-resistant Enterococcus faecium reveals spread of a linear plasmid conferring a nutrient utilization advantage

2021 ◽  
Author(s):  
Mathilde Boumasmoud ◽  
Vanina Dengler Haunreiter ◽  
Tiziano A. Schweizer ◽  
Lilly Meyer ◽  
Bhavya Chakrakodi ◽  
...  
Keyword(s):  
Enterococcus Faecium ◽  
Evolutionary Dynamics ◽  
Tertiary Care ◽  
Nutrient Utilization ◽  
Control Measures ◽  
Phylogenomic Analysis ◽  
Vancomycin Resistant Enterococcus ◽  
Transmission Networks ◽  
Vancomycin Resistant ◽  
Healthcare Associated

Healthcare-associated outbreaks of vancomycin-resistant Enterococcus faecium (VREfm) are a worldwide problem with increasing prevalence. The genomic plasticity of this hospital-adapted pathogen contributes to its efficient spread despite infection control measures. Here, we aimed to identify the genomic and phenotypic determinants of healthcare-associated transmission of VREfm. We assessed the VREfm transmission networks at the tertiary-care University Hospital of Zurich (USZ) between October 2014 and February 2018 and investigated microevolutionary dynamics of this pathogen. We performed whole-genome sequencing for the 69 VREfm isolates collected during this timeframe and assessed the population structure and variability of the vancomycin resistance transposon. Phylogenomic analysis allowed us to reconstruct transmission networks and to unveil external or indirect transmission networks, not detectable by traditional surveillance. Notably, it unveiled a persistent clone, sampled 31 times over a 29-month period. Exploring the evolutionary dynamics of this clone and characterizing the phenotypic consequences revealed the spread of a variant with decreased daptomycin susceptibility and the acquired ability to utilize N acetyl galactosamine (GalNAc), one of the primary constituents of the human gut mucins. This nutrient utilization advantage was conferred by a novel plasmid, termed pELF_USZ, which exhibited a linear topology. This plasmid, which was harbored by two distinct clones, was transferable by conjugation. Overall, this work provides an example of the potential of the integration of epidemiological, functional genomic and evolutionary perspectives to understand adaptation strategies contributing to the successful spread of VREfm.

scholarly journals Occurrence of antibiotic-resistant bacterial strains isolated in poultry

2012 ◽  
Vol 47 (No. 2 - 3) ◽  
pp. 52-59 ◽  
Author(s):  
M. Kolář ◽  
R. Pantůček ◽  
J. Bardoň ◽  
I. Vágnerová ◽  
H. Typovská ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Enterococcus Faecium ◽  
Bacterial Species ◽  
Clinical Importance ◽  
Control Group ◽  
Vancomycin Resistant Enterococcus ◽  
Bacterial Strains ◽  
Antibiotic Resistant ◽  
Vancomycin Resistant ◽  
High Level

The main goal of the study was to analyse the occurrence of antibiotic-resistant bacterial strains in poultry in the Czech Republic in 1999&ndash;2000. The resistance was determined in 128 selected Escherichia coli, 88 Staphylococcus sp. and 228 Enterococcus sp. strains. The bacterial species were selected to represent gramnegatives and grampositives, the common part of intestinal microflora and also opportunistic pathogens. In Escherichia coli, 97% of strains were found to be resistant to tetracycline, 51% were resistant to ampicillin, and 31% were resistant to piperacillin. Increased frequencies of resistance to ofloxacin and ciprofloxacin (in 10% of the strains) were also found. In staphylococci, increased numbers of strains resistant to erythromycin (39%), clindamycin (19%), tetracycline (14%) and ofloxacin (13%) were observed. In enterococci, 80%, 59% and 34% of the strains were resistant to tetracycline, erythromycin or nitrofurantoin, respectively. A high-level resistance to streptomycin was proved in 22% of the strains. Eleven Enterococcus sp. strains were found to be resistant to vancomycin (vancomycin-resistant enterococci &ndash; VRE). Being of the clinical importance, the VRE strains were analysed in detail. Six VRE were identified as Enterococcus faecium VanA, three strains belonged to Enterococcus sp. group III VanB. The remaining two strains were classified as Enterococcus faecium VanB and Enterococcus faecalis VanB, respectively. Based on SmaI macrorestriction analysis, regardless of their resistance type, vancomycin-resistant Enterococcus faecium strains formed a cluster distinct from the control group of vancomycin sensitive strains. Furthermore, within the cluster of vancomycin resistant Enterococcus faecium strains, two clonal lines could be distinguished while the sensitive strains were more heterogeneous.

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