Comparison of antibiotic resistance and virulence in vancomycin-susceptible and vancomycin-resistant Enterococcus faecium strains

2019 ◽  
Vol 87 (4) ◽  
pp. 195-203
Author(s):  
Anna Sieńko ◽  
Sławomir Czaban ◽  
Dominika Ojdana ◽  
Piotr Majewski ◽  
Anna Wieczorek ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Enterococcus Faecium ◽  
Virulence Genes ◽  
Susceptibility Testing ◽  
Surface Protein ◽  
Hospital Environment ◽  
Vancomycin Resistant Enterococcus ◽  
Biofilm Production ◽  
Long Time ◽  
Vancomycin Resistant

Aim. Today, infections caused by vancomycin-resistant Enterococcus faecium (VRE) are a major problem in the healthcare system. The aim of this study was to compare the antibiotic resistance and virulence traits between vancomycin-susceptible E. faecium (VSE) and VRE clinical isolates.Material and Methods. Studies were performed on 66 E. faecium (32 VRE and 34 VSE) strains. Susceptibility testing and identification were performed, and strains were examined for ß-lactamase, hemolysin and biofilm production. Isolates were tested for the presence of 5 van genes, 8 virulence genes and 6 aminoglycoside-modifying enzyme (AME) genes. Obtained amplicons were subjected to electrophoretical separation and DNA sequencing.Results. Among 32 VRE isolates, 28 were found to have the VanA phenotype, and 4 the VanB. The most frequent resistance and virulence profile among VRE strains was resistance to ampicillin, imipenem, gentamicin, streptomycin, teicoplanin, and vancomycin with enterococcal surface protein (esp), endocarditis antigen (efaA), collagen adhesin (acm), and hialuronidase (hyl) genes; among VSE: resistance to ampicillin, imipenem, gentamicin, streptomycin with esp, efaA, acm, and hyl genes. Conclusions. Our findings prove that both VRE and VSE strains were well equipped with virulence and resistance genes, although VRE strains were characterized by a greater variety and a higher number of these genes. However, statistical analysis revealed no significant differences between VSE and VRE strains (p > 0.05). Nevertheless, our results suggest that VRE strains may slowly acquire and incorporate resistance and virulence genes, due to their ability to survive in a hospital environment for a long time.

Analysis of biofilm production in Enterococcus faecium strains depending on clinical source

2017 ◽  
Vol 7 (1) ◽  
pp. 83-89
Author(s):  
A. Sieńko ◽  
P. Wieczorek ◽  
P. Majewski ◽  
P. Sacha ◽  
A. Wieczorek ◽  
...  
Keyword(s):  
Blood Group ◽  
Enterococcus Faecium ◽  
Gel Electrophoresis ◽  
Virulence Genes ◽  
Susceptibility Testing ◽  
Infection Group ◽  
Biofilm Production ◽  
Rectal Swabs ◽  
Phenotypic Methods ◽  
Clinical Source

Purpose: Enterococcus faecium strains have been reported worldwide as etiologic factors of many nosocomial infections, which are difficult to manage because of the constantly increasing resistance of these microorganisms to antibiotics and the ability to form biofilm. The aim of this study was to analyze the ability to produce a biofilm in E. faecium strains, depending on the patient’s clinical material. Materials and methods: Sixty-six E. faecium strains were investigated. Identification and susceptibility testing were conducted by the VITEK2 system. The ability to form biofilm was assessed by phenotypic methods. The presence of selected virulence genes was established by PCR followed by gel electrophoresis and sequencing. Results: Among the tested E. faecium isolates, 72.7% were biofilm-positive (BIO+) and 27.3% biofilm-negative (BIO-). Strains were collected mostly from rectal swabs (30.4%) and blood (18.3%). BIO+ strains from infections constituted 31.8% (52.4% isolated from blood) and from colonization 40.9% (48.2% from rectal swabs). 91.7% of the Blood Group strains and 68.5% of the Other Group strains produced biofilm. Strains from the Colonization Group produced biofilm in a proportion similar to the Infection Group (about 75%). There were no statistically significant differences in virulence and resistance, except for vancomycin (more resistant BIO+ Other than the BIO+ Blood Group, and more resistant BIO+ Colonization than BIO+ Infection Group) and teicoplanin (more resistant BIO+ Colonization than the BIO+ Infection Group). Conclusion: The majority of E. faecium isolates carries high levels of resistance to many antimicrobials, is well equipped with virulence genes, and possesses the ability to form biofilm.

scholarly journals Development of Daptomycin Susceptibility Breakpoints for Enterococcus faecium and Revision of the Breakpoints for Other Enterococcal Species by the Clinical and Laboratory Standards Institute

2019 ◽  
Author(s):  
Michael J Satlin ◽  
David P Nicolau ◽  
Romney M Humphries ◽  
Joseph L Kuti ◽  
Shelley A Campeau ◽  
...  
Keyword(s):  
Enterococcus Faecalis ◽  
Enterococcus Faecium ◽  
Susceptibility Testing ◽  
Treatment Options ◽  
Vancomycin Resistant Enterococcus ◽  
Standard Dosage ◽  
Enterococcal Species ◽  
Vancomycin Resistant ◽  
Infectious Diseases Consultation ◽  
Dose Dependent

Abstract Daptomycin is one of the few treatment options for infections caused by enterococci that are resistant to ampicillin and vancomycin, such as vancomycin-resistant Enterococcus faecium. The emergence and clinical significance of daptomycin-resistant enterococci and evolving microbiologic, pharmacokinetic-pharmacodynamic, and clinical data indicated that the pre-2019 Clinical and Laboratory Standards Institute (CLSI) susceptible-only breakpoint of ≤4 μg/mL for daptomycin and enterococci was no longer appropriate. After analyzing data that are outlined in this article, the CLSI Subcommittee on Antimicrobial Susceptibility Testing established new breakpoints for daptomycin and enterococci. For E. faecium, a susceptible dose-dependent (SDD) breakpoint of ≤4 μg/mL was established based on an increased dosage of 8–12 mg/kg/day (≥8 μg/mL-resistant). CLSI suggests infectious diseases consultation to guide daptomycin use for the SDD category. For Enterococcus faecalis and other enterococcal species, revised breakpoints of ≤2 μg/mL-susceptible, 4 μg/mL-intermediate, and ≥8 μg/mL-resistant were established based on a standard dosage of 6 mg/kg/day.

Colonization pattern of vancomycin-resistant Enterococcus faecium

1994 ◽  
Vol 22 (4) ◽  
pp. 202-206 ◽  
Author(s):  
E YAMAGUCHIE ◽  
F VALENA ◽  
S SMITH ◽  
A SIMMONS ◽  
R ENG
Keyword(s):  
Enterococcus Faecium ◽  
Vancomycin Resistant Enterococcus ◽  
Colonization Pattern ◽  
Vancomycin Resistant
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