Phenotypic speciation of enterococci with special reference to prevalence, virulence and antimicrobial resistance (original) (raw)
Related papers
IOSR Journals , 2019
Enterococci, once regarded as commensal flora are emerging as pathogen for multiple human infections. Their intrinsic resistance and properties of quick acquisition of resistance towards many in use and reserve antimicrobials draws the problem statement for these bacteria. The study eyes to determine the prevalence of Enterococccal infections and their antimicrobial susceptibility pattern to create a database and formulate guidelines for the empirical treatment. A prospective study was done over a period of 12 months in a rural tertiary care hospital enrolling patients having features of infections. Various samples were collected depending on clinical syndromes following criteria of inclusion and exclusion. Culture of samples was done followed by identification of resultant organisms including Enterococcus spp. as per standard guidelines. Antimicrobial susceptibility testing done for Enterococci isolates only by conventional disc diffusion method following CLSI guideline. Vancomycin resistance was tested by disc diffusion and Vancomycin screen agar method. In one year period a total 350 samples were cultured from different clinical cases. 173 of them were culture positive and 34 samples yielded Enterococus spp. Enterococus faecalis and Enterococus faecium isolates were 32 and two in number respectively. The overall prevalence of Enterococci was 9.71%. All Enterococci isolates were susceptible to Vancomycin, Linezolid, Teicoplanin. E. Faecalis was still susceptible towards Nitrofurantoin (86.2%), and HL Gentamicin (68.75%), HL Streptomycin (56%) but to a lesser extent to Fluoroquinolones, Chloramphenicol (21.86%) and Ampicillin (31.25%). E. faecium isolates were resistant to Fluoroquinolones , Chloramphenicol , HL Streptomycin (100%) and were susceptible to Nitrofurantoin, and HL Gentamicin, Ampicillin (50%). Vancomycin resistance among Enterococci was not an emerging problem in this geographic area. Prevalence of Enterococcus faecalis was higher than Enterococcus faecium. Enterococcus faecium was more drug resistant than Enterococcus faecalis.
Enterococcal infections and antimicrobial resistance in a tertiary care hospital, Eastern India
Background and study aim: During last two decades, there has been a world-wide trend in increasing occurrence of enterococcal infections in the hospitals. The aim of present study was to determine the spectrum of enterococcal infections, species prevalence, antimicrobial and characteristics of vancomycin resistant enterococci (VRE) in a tertiary care hospital, Eastern India. Patients and Methods: Between January 2013 and July 2014, 152 Enterococcus species were obtained from clinical samples. Enterococci were identified using standard biochemical tests. Antimicrobial susceptibility was tested by Kirby-Bauer disk diffusion according to Clinical resistance & Laboratory Standards Institute (CLSI) guidelines.VRE agar base was used to screen VRE isolates. Minimum inhibitory concentration (MIC) values of VRE isolates were determined using Epsilometer-test. VRE isolates were also examined by PCR to detect vanA gene. Results: From 1602 clinical samples, 961 (60%) were culture positive and 152 (15.8%) enterococcal isolates were obtained. Most common species isolated was E. faecalis (63.8%) followed by E. faecium (35.5%). Majority of enterococcal infections were detected from ICUs and surgical wards and clinically presented as UTIs. Disk diffusion method showed 67.1% were resistant to penicillin, 61.2% ampicillin, 58.5% ciprofloxacin, 46.7% high-level gentamicin, 42. 8% high-level streptomycin, 7.9% teicoplanin and none to linezolid. Twenty (13.2%) enterococcal isolates were vancomycin resistant in VRE screen and disk diffusion method. Epsilometer-test of VRE isolates showed 8 (40%) isolates were resistant and 9 (45%) were intermediately resistant. From 20 VRE isolates, six showed VanA and two VanB phenotypes and all six VanA phenotypes had vanA gene cluster. Conclusion: More accurate and reliable MIC determination tests should be performed in all suspected VRE isolates. Confirmatory PCR is required for identifying resistant gene cluster. Key words: Enterococci, E. faecalis, E. faecium, VRE, vanA gene
Prevalence and Antibiotic Resistance Pattern of Isolated Enterococcus by Standard Techniques
https://www.ijhsr.org/IJHSR\_Vol.12\_Issue.11\_Nov2022/IJHSR-Abstract02.html, 2022
Introduction: Enterococci have emerged as important nosocomial pathogens and appearance of resistance to many of the antimicrobials used for Gram-positive organisms has made the management of infections due to Enterococcus species difficult. Aim: Aim of the study was to observe the prevalence rate of Enterococcus species and observe its antibiotic resistance pattern in our hospital. Method: Enterococci strains were isolated from various clinical samples by culture and biochemical methods and its antibiotic susceptibility testing was seen by Kirby Bauer method as per CLSI guidelines. Minimum inhibitory concentration (MIC) determination for detecting Vancomycin resistance was done by HiMedia E strip test. Result: In 200 clinical isolates of Enterococcus, 170 were Enterococcus faecalis and 30 species were Enterococcus faecium. Out of 200 Enterococcus isolates 29 were VRE. Conclusion: The prevalence of Enterococcus species was 5.70% and vancomycin resistance among Enterococci isolates in this study was 14.5% and. Treating serious infections caused by vancomycinresistant Enterococci has emerged as one of the leading clinical challenges for physicians because of limited therapeutic options.
Enterococcal infection is a life threatening systemic infection prevalent in developing countries like India and is a major public health problem.Enterococciare important nosocomial pathogen of human disease; second most common cause of nosocomial urinary tract and wound infections; third most common cause of nosocomial bacteremias. Because of their resistance to different antimicrobial agents these bacteria are often involved in serious super-infections among patients receiving broad-spectrum anti-microbial therapy. Correct diagnosis is crucial in proper management of Enterococcal infection, so laboratory tests are essential to establish identification of Enterococcal species. The study was conducted to isolate and characterize Enterococcus species from different clinical samples and to perform antimicrobial susceptibility testing in all age groups and both genders. Out of 200 Enterococcal species isolated, 164 (82%) were E. faecalis and 34 (17%) were E. faecium; majority were isolated from urine (60%) and blood (35.5%); they showed more resistance to penicillin (92%), less resistance to vancomycin (1%) and no resistance to linezolid (0%).
Pars of Jahrom University of Medical Sciences, 2016
Introduction: Epidemiology of Enterococcus infections has attracted much attention. Precise identification of pathogenic strains can be effective in the control process of microorganism antibiotic resistance. This study aimed to identify the Enterococcus species isolated from hospitals in Tehran and examine their antibiotic resistance pattern by phenotypic and genotypic methods. Methods & Materials: This study was performed on 400 clinical samples from different hospitals in Tehran during 2015-2016. Specific cultures and biochemical tests were used to identify Enterococcus, distinguish E. faecalis and E. faeacium species and PCR method was used to identify Enterococcus species. Antibiotic susceptibility was examined using Kirby-Bauer disc diffusion, and CLSI and vancomycin MIC were measured using broth dilution. Results: Of the 400 samples, 278 Enterococcus species were recognized. Phenotypic methods recognized 70.86% E. faecalis, 15.46% E. faeacium and 13.68% other species. PCR identified 72.3% E. faecalis, 10.43% E. faeacium and 17.27% other Enterococcus species. Results of the antibiograms showed the highest resistance (83.34%) to quinupristin/dalfopristin, and the lowest (1.41%) to linezolid. Also, resistance to vancomycin was observed in 5.95% with MIC ≥ 512 µg/ml in 9 cases. Conclusion: Rapid diagnosis can prevent massive outbreaks of Enterococcus. Given the prevalence of vancomycin resistance in Enterococcus, preventive measures are imperative. The right antibiotics should be prescribed according to the resistance patterns after susceptibility test is performed for each patient.
Advances in microbiology, 2023
In this work, we evaluated biofilm formation of Vancomycin Resistant of E. faecalis and E. faecium (VRE) in different culture media and adhesion substrate, as well as cellular hydrophobicity and presence of virulence genes. For this, 35 isolates were collected from a public hospital in Recife, Pernambuco, Brazil and identified by the Matrix-Assisted Laser Desorption Ionization-Time-of-flight-Mass Spectrometry (MALDI-TOF-MS) technique. Biofilm formation was analyzed by the Crystal Violet (CV) method and fluorescence microscopy, cellular hydrophobicity by hydrocarbon interaction and the presence of gelE, esp and asa1 genes by Polymerase Chain Reaction (PCR). 12 isolates were identified as E. faecalis and 23 as E. faecium. Most were obtained in Coronary Units (40.0%) and Intensive Care Unit (31.4%). E. faecium isolates were more resistant to the antibiotics tested than E. faecalis; however, E. faecalis stood out as a biofilm producer. Regarding the presence and gene frequency, it was observed that gelE (54.3%) and esp (54.3%) were the most prevalent, followed by asa1 (22.9%). When comparing the gene frequency, it was observed that gelE and esp were predominant (48.6% for both species), while asa1 was more frequent in E. faecalis (20.0%). The data presented here are worrying, because they reveal the virulence potential of isolates VRE, which contributes to the dissemination and persistence of these pathogens in the hospital environment.
Journal of Evolution of Medical and Dental Sciences, 2017
BACKGROUND Enterococci constitute a significant proportion of the normal flora of the oropharynx, gastrointestinal and genitourinary tract. The incidence of Enterococcal infections is on the rise over the past few years. Enterococci are resistant to a number of drugs including β-lactamase glycopeptides and aminoglycosides limiting the options for treatment. Aims and Objectives-The aim of the study is to speciate the enterococci isolated from clinical specimens and to determine the prevalence of High Level Gentamycin and Vancomycin resistance among the isolates. MATERIALS AND METHODS In the present study, a total of 50 strains of Enterococci were isolated from various clinical samples collected over a period of 6 months. Speciation of the isolates and their resistance to HLG and Vancomycin were determined by disc diffusion and E-test. RESULTS The maximum no. of isolates were from female and urine constituted the most common sample with highest yield. E. faecalis was the most common species. HLGR Enterococci was formed in 13/50 strain, only one strain 1/50 of enterococci was vancomycin resistant. CONCLUSION HLG and vancomycin resistance among enterococci should be monitored to prevent the transfer of resistance genes to other bacteria. It also helps to improve therapy and control nosocomial spread of enterococci.
Bangladesh Journal of Medical Science
Background: Enterococci, formerly classified with fecal streptococci, have been recognized to be of fecal origin since the beginning of this century. Method: This study was undertaken to determine the prevalence of stool colonization with vancomycin resistant Enterococcus (VRE) and also to evaluate the risk factors for colonization with vancomycin resistant Enterococcus among non- Hospitalized individuals at MMIMSR, Mullana.Test was performed for VRE isolates collected over a period of 6 months (Oct2015- March 2016). Faecal samples were collected by using sterile container from non- hospitalized individuals then to Cultures using Mac Conkey and Blood agar. After presumptive diagnosis as an enterococcus spp, 50 Enterococcal isolates were then again cultured on special VRE screen agar media to identify vancomycin resistant Enterococcus. Result: The results were further supported by modified Kirby-bauer disk diffusion method with vancomycin (30μg) as per CLSI guideline. A total of 29 (...
National Journal of Medical Research, 2013
Introduction: The present study was carried out to determine the species of Enterococci isolated from various clinical samples and to determine its antimicrobial susceptibility pattern. Enterococci have emerged as an important cause of nosocomial infections and antibiotic resistance among Enterococcus is a major obstacle for treatment. Material and methods: Enterococcus spp. were isolated and identified from different clinical samples between Sept. 2012 to Aug. 2013 by standard biochemical test. Antimicrobial susceptibility testing was performed by modified Kirby bauers disc diffusion method as per CLSI guidelines. Result: Among the 100 isolates of Enterococcus from various clinical samples maximum isolates were from urine sample 70% and E. faecalis 92% constituted the predominant isolate. They were found to be susceptible to linezolid and vancomycin with least sensitive to ciprofloxacin and tetracycline. Conclusion: Routine speciation and in vitro antimicrobial susceptibility testing of Enterococcus in various clinical samples is emphasized due to the prevalence of wide variety of Enterococcus species and also appearance of high resistant strains.