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..

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.

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 To determine antimicrobial susceptibility and biofilm production among coagulase negative staphylococci at a tertiary care hospital

2021 ◽  
Vol 8 (3) ◽  
pp. 230-234
Author(s):  
Naga Sri Latha Bathala ◽  
M Sasidhar ◽  
S Kusuma Bai
Keyword(s):  
Drug Resistance ◽  
Antimicrobial Susceptibility ◽  
Biofilm Formation ◽  
Antimicrobial Agents ◽  
Tertiary Care ◽  
Multi Drug Resistance ◽  
Clinical Samples ◽  
Care Hospital ◽  
Coagulase Negative Staphylococci ◽  
Cross Sectional

CoNS are gaining importance due to increase in resistance rates to betalactam antibiotics and multi drug resistance. Although specific virulence factors are not as clearly established, it seems clear that factors such as bacterial polysaccharide components, and ability to form biofilm are involved in attachment and/or persistence of bacteria on foreign materials. Biofilms usually result in persistent infections that cannot be easily resolved with standard antibiotic treatments; therefore, the biofilm formation ability and the resistance to antimicrobial therapy can be intimately related. A prospective cross-sectional study was done on purely isolated CoNS from various clinical samples from both out patients and inpatients. All the test strains were subjected to antimicrobial susceptibility testing. The ability to produce biofilm was detected by tube adherence method. Among 193 CoNS isolates 156 were from inpatients and 37 were from out patients. Methicillin resistant was seen in 80.31%. Of the total, 40.41% showed moderate biofilm formation by tube adherence method. 23.32% of isolates did not form biofilm. All the isolates from blood samples showed moderate (20/26) and strong (6/26) biofilm formation. Among non biofilm producers 66.67% were MS CoNS isolates and 33.33% were MRCoNS. 94.59% of biofilm producers were MRCoNS and 5.41% were MSCoNS. Production of biofilm was relatively more (1.16) among CoNS isolates of IPD than OPD.  As Coagulase negative Staphylocooci are exhibiting multi drug resistance and are able to form biofilm, these organisms causing a major challenge for the physicians. Hence, such problems can be prevented by detection of biofilm producers and appropriate antibiotic doses modification. The issue of antibiotic resistance among CoNS needs to be addressed through a more rational use of existing antibiotics as well as the development of new antimicrobial agents.

scholarly journals Antibiotic susceptibility pattern of biofilm producing Staphylococci isolated from different clinical samples

2020 ◽  
Author(s):  
Ratna Shova Tuladhar ◽  
Raju Shrestha ◽  
Sunil Lekhak ◽  
Mahesh Chaudhary ◽  
Sarita Manandhar
Keyword(s):  
Biofilm Formation ◽  
Negative Impact ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
Clinical Specimen ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital ◽  
Patient Health ◽  
Phenotypic Methods

Abstract Background: Biofilm mediated infection by Staphylococci have a significant negative impact on patient health and necessitate reliable method for detecting biofilm producers. The ability of isolates to produce biofilm make them resistant to host immune response as well as available antibiotics. This study aims to detect biofilm producing ability among clinical staphylococci by phenotypic methods and presence of icaAD genes as well as their antibiotic profile. Methods: A total of 4063 different clinical specimen received in the tertiary care hospital of Nepal were examined and Staphylococci were identified following standard microbiological procedure. The antibiotic resistivity pattern was detected by Kirby Bauer disc diffusion method whereas biofilm formation was detected by three phenotypic methods viz. congo red agar (CRA), tube method (TM) and tissue culture plate (TCP) method. Furthermore, icaAD genes were detected by PCR method. Results: A total of 161 Staphylococci were isolated comprising S. aureus (63, 39.1%) and CNS (98, 60.9%). The isolates were found to be resistant to penicillin and erythromycin. Strong biofilm formation was detected among 6 (3.7%), 22 (13.7%) and 35 (21.7%) by CRA, TM and TCP method respectively. Similarly, among 24 (14.9%) isolates icaAD genes were detected. Biofilm formation was found to be correlated with methicillin resistance. Conclusion: The study showed significant association between phenotypic production of biofilm and presence of ica genes. The biofilm producing isolates were found to be resistant to antibiotics than biofilm non producers.

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 Characterization, speciation and antimicrobial resistance pattern of Enterococcus species isolated from clinical specimens at a rural tertiary care hospital

2017 ◽  
Vol 5 (8) ◽  
pp. 3484
Author(s):  
Shweta Jaiswal ◽  
Amit Singh ◽  
Rajesh K. Verma ◽  
Dharmendra P. Singh ◽  
Sunita Kumari
Keyword(s):  
Tertiary Care ◽  
Vancomycin Resistance ◽  
High Rate ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Susceptibility Pattern ◽  
Antimicrobial Susceptibility Pattern ◽  
Resistance To Penicillin

Background: Enterococci have attracted much attention in recent years due to their increased recognition as a cause of nosocomial infection. They exhibit vancomycin resistance with increasing frequency so that determination of antimicrobial susceptibility pattern is necessary. Aim of present study is to determine the prevalence and susceptibility pattern of Enterococci in rural tertiary care hospital.Methods: Total of 100 Enterococcus isolated from various clinical samples were identified and speciated by Vitek®2 compact system (BIOMERIEUX). Antibiotic susceptibility was determined by modified Kirby Bauer disc diffusion method. Results were interpreted as per CLSI guidelines and vancomycin MIC was determined by E-test method.Results: Out of 100 Enterococcus strains 47 were E. faecalis, 51 were E. faecium, 02 were E. gallinarum and 01 was E. cassaliflavus. Resistance to penicillin, ampicillin, ciprofloxacin, elevated level gentamycin and high-level streptomycin were observed. All isolates were sensitive to linezolid and teicoplanin, 6% strains showed vancomycin resistance by E-test.Conclusions: High rate of resistance to penicillin, ciprofloxacin and aminoglycosides is observed and emergence of VRE has further worsened this situation. So, there is an urgent need for more rational use of antimicrobials and infection control.

scholarly journals Incidence of Vancomycin Resistant Phenotype of the Methicillin Resistant Staphylococcus aureus Isolated from a Tertiary Care Hospital in Lahore

Antibiotics ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 3 ◽  
Author(s):  
Aqib Saeed ◽  
Fatima Ahsan ◽  
Muhammad Nawaz ◽  
Khadeja Iqbal ◽  
Kashif Rehman ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Resistance Gene ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Vancomycin Resistance ◽  
Diffusion Method ◽  
Care Hospital ◽  
Methicillin Resistant ◽  
Vancomycin Resistant

Staphylococcus aureus (S. aureus)-associated infections are one of the major threats to public health. The aim of the present study was to determine the antibiotic resistance pattern as well as the genetic characterization of methicillin and vancomycin resistant S. aureus (VRSA) isolated from a tertiary care hospital in Lahore. The S. aureus isolates were isolated from different clinical samples, identified by biochemical testing, and subjected to antibiotic susceptibility testing via the disc diffusion method or broth microdilution method. The methicillin resistance gene (mecA) and vancomycin resistance gene (vanA) were amplified by the polymerase chain reaction. The S. aureus isolates showed high incidences of resistance against methicillin (76%) and moderate incidences of resistance to vancomycin (14%). Isolates were also resistant to several other drugs, such as cefoxitin (76%), ertapenem (83%), ampicillin (81%), tobramycin (78%), moxifloxacin (76%), and tetracycline (74%). An encouraging finding was that 98% of isolates were susceptible to tigecycline, indicating its possible role in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) and VRSA, as well as the multi-drug resistant S. aureus. The mecA gene was detected in 33.3% of tested isolates (10/30), while the vanA gene was also detected in 30% (9/30) of the tested isolates. In conclusion, the frequent presence of methicillin and vancomycin resistance in S. aureus appraises the cautious use of these antibiotics in clinical practices. Furthermore, it is suggested that there should be continuous monitoring of tigecycline treatments in clinical setups in order to delay the development of resistance against it.

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