scholarly journals Novel Multidrug-Resistant Enterococcal Mobile Linear Plasmid pELF1 Encoding vanA and vanM Gene Clusters From a Japanese Vancomycin-Resistant Enterococci Isolate

2019 ◽  
Vol 10 ◽  
Author(s):  
Yusuke Hashimoto ◽  
Makoto Taniguchi ◽  
Kazuma Uesaka ◽  
Takahiro Nomura ◽  
Hidetada Hirakawa ◽  
...  
Keyword(s):  
Gene Clusters ◽  
Multidrug Resistant ◽  
Linear Plasmid ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant

scholarly journals Novel genomic islands and a new vanD-subtype in the first sporadic VanD-type vancomycin resistant enterococci in Norway

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255187
Author(s):  
Mushtaq T. S. AL Rubaye ◽  
Jessin Janice ◽  
Jørgen Vildershøj Bjørnholt ◽  
Aleksandra Jakovljev ◽  
Maria Elisabeth Hultström ◽  
...  
Keyword(s):  
Gene Clusters ◽  
Vancomycin Resistance ◽  
Genomic Islands ◽  
Vancomycin Resistant Enterococci ◽  
Chromosomal Site ◽  
Enterococcus Casseliflavus ◽  
Temporal Occurrence ◽  
Vancomycin Resistant ◽  
High Level

Background Vancomycin-resistant enterococci (VRE) represent several types of transferable vancomycin resistance gene clusters. The vanD type, associated with moderate to high level vancomycin resistance, has only sporadically been described in clinical isolates. The aim of this study was to perform a genetic characterization of the first VanD-type VRE strains detected in Norway. Methods The VanD-type VRE-strains (n = 6) from two patient cases were examined by antimicrobial susceptibility testing and whole genome sequencing (WGS) to uncover Van-phenotype, strain phylogeny, the vanD gene clusters, and their genetic surroundings. The putative transferability of vanD was examined by circularization PCR and filter mating. Results The VanD-type Enterococcus faecium (n = 4) and Enterococcus casseliflavus (n = 2) strains recovered from two cases (A and B), expressed moderate to high level vancomycin resistance (MIC 64—>256 mg/L) and various levels of teicoplanin susceptibility (MIC 2—>256 mg/L). WGS analyses revealed phylogenetically different E. faecium strains (A1, A2, and A3 of case A and B1 from case B) as well as vanD gene clusters located on different novel genomic islands (GIs). The E. casseliflavus strains (B2 and B3 of case B) were not clonally related, but harbored nearly identical novel GIs. The vanD cluster of case B strains represents a novel vanD-subtype. All the vanD-GIs were integrated at the same chromosomal site and contained genes consistent with a Clostridiales origin. Circular forms of the vanD-GIs were detected in all strains except B1. Transfer of vanD to an E. faecium recipient was unsuccessful. Conclusions We describe the first VanD-type E. casseliflavus strains, a novel vanD-subtype, and three novel vanD-GIs with a genetic content consistent with a Clostridiales order origin. Despite temporal occurrence, case A and B E. faecium strains were phylogenetically diverse and harbored different vanD subtypes and vanD-GIs.

scholarly journals High Colonization Rate and Heterogeneity of ESBL- and Carbapenemase-Producing Enterobacteriaceae Isolated from Gull Feces in Lisbon, Portugal

2020 ◽  
Vol 8 (10) ◽  
pp. 1487
Author(s):  
Marta Aires-de-Sousa ◽  
Claudine Fournier ◽  
Elizeth Lopes ◽  
Hermínia de Lencastre ◽  
Patrice Nordmann ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Bacterial Species ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Multidrug Resistant Bacteria ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Encoding Genes

In order to evaluate whether seagulls living on the Lisbon coastline, Portugal, might be colonized and consequently represent potential spreaders of multidrug-resistant bacteria, a total of 88 gull fecal samples were screened for detection of extended-spectrum β-lactamase (ESBL)- or carbapenemase-producing Enterobacteriaceae for methicillin-resistant Staphylococcus aureus (MRSA) and for vancomycin-resistant Enterococci (VRE). A large proportion of samples yielded carbapenemase- or ESBL-producing Enterobacteriaceae (16% and 55%, respectively), while only two MRSA and two VRE were detected. Mating-out assays followed by PCR and whole-plasmid sequencing allowed to identify carbapenemase and ESBL encoding genes. Among 24 carbapenemase-producing isolates, there were mainly Klebsiella pneumoniae (50%) and Escherichia coli (33%). OXA-181 was the most common carbapenemase identified (54%), followed by OXA-48 (25%) and KPC-2 (17%). Ten different ESBLs were found among 62 ESBL-producing isolates, mainly being CTX-M-type enzymes (87%). Co-occurrence in single samples of multiple ESBL- and carbapenemase producers belonging to different bacterial species was observed in some cases. Seagulls constitute an important source for spreading multidrug-resistant bacteria in the environment and their gut microbiota a formidable microenvironment for transfer of resistance genes within bacterial species.

Enterokokken mit speziellen Resistenzen – Epidemiologie, Hygiene und Therapie

2019 ◽  
Vol 144 (08) ◽  
pp. 553-560 ◽  
Author(s):  
Alexander Mischnik ◽  
Guido Werner ◽  
Jennifer Bender ◽  
Nico Mutters
Keyword(s):  
Scientific Evidence ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Vancomycin Resistant Enterococci ◽  
Resistance Patterns ◽  
Single Intervention ◽  
Vancomycin Resistant ◽  
Meta Analyses ◽  
Resistance Rates ◽  
Insight Into

AbstractEnterococci with special resistance patterns (mainly vancomycin-resistant enterococci) play an important role in everyday clinical practice. Rising resistance rates to linezolid, daptomycin or tigecycline are also increasingly reported. Therapeutically, linezolid and daptomycin are the most important substances mainly in infections due to vancomycin-resistant enterococci. Several systematic meta-analyses of bloodstream infections showed discrepant results in the comparison of mortality of linezolid and daptomycin-treated bacteraemias. The containment of enterococci with special resistance patterns is currently receiving great attention. The key hygienic issue in all recommendations for dealing with multidrug-resistant enterococci can be summarized very simply: current scientific evidence is often inconsistent and studies that have clearly tested a single intervention for efficacy are lacking. The present work gives an insight into the current epidemiology and therapeutic strategies. Furthermore, the recently published German KRINKO recommendations are presented.

scholarly journals Differences in Hospital-Associated Multidrug-Resistant Organisms and Clostridium difficile Rates Using 2-Day versus 3-Day Definitions

2014 ◽  
Vol 35 (11) ◽  
pp. 1417-1420 ◽  
Author(s):  
Adrijana Gombosev ◽  
Salah E. Fouad ◽  
Eric Cui ◽  
Chenghua Cao ◽  
Leah Terpstra ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Clostridium Difficile ◽  
Infection Prevention ◽  
Prevention Programs ◽  
Multidrug Resistant ◽  
Infect Control Hosp ◽  
Methicillin Resistant ◽  
Vancomycin Resistant Enterococci ◽  
Multidrug Resistant Organisms ◽  
Vancomycin Resistant

We surveyed infection prevention programs in 16 hospitals for hospital-associated methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci, extended-spectrum β-lactamase, and multidrug-resistant Acinetobacter acquisition, as well as hospital-associated MRSA bacteremia and Clostridium difficile infection based on defining events as occurring >2 days versus >3 days after admission. The former resulted in significantly higher median rates, ranging from 6.76% to 45.07% higherInfect Control Hosp Epidemiol 2014;35(11):1417–1420

scholarly journals Increasing proportion of vancomycin resistance among enterococcal bacteraemias in Switzerland: a 6-year nation-wide surveillance, 2013 to 2018

2020 ◽  
Vol 25 (35) ◽  
Author(s):  
Vanja Piezzi ◽  
Michael Gasser ◽  
Andrew Atkinson ◽  
Andreas Kronenberg ◽  
Danielle Vuichard-Gysin ◽  
...  
Keyword(s):  
Multidrug Resistant ◽  
Vancomycin Resistance ◽  
Targeted Prevention ◽  
Prevention Strategies ◽  
Confidential Interval ◽  
Blood Isolate ◽  
Epidemiological Factors ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Using Data

Background Vancomycin-resistant enterococci (VRE), mostly Enterococcus faecium, are multidrug-resistant microorganisms that can cause nosocomial infections. VRE has increased throughout many European countries, but data from Switzerland are scarce. Aim The aim of this work was to characterise the epidemiology of enterococcal bacteraemias in Switzerland with a focus on VRE. Methods In this observational study, we retrospectively investigated bacteraemias from 81 healthcare institutions from January 2013 to December 2018 using data from the Swiss Centre for Antibiotic Resistance. Only the first blood isolate with E. faecalis or E. faecium from an individual patient was considered. We analysed the annual incidences of enterococcal bacteraemias and determined the proportion of VRE over time. We also assessed epidemiological factors potentially associated with VRE bacteraemia. Results We identified 5,369 enterococcal bacteraemias, of which 3,196 (59.5%) were due to E. faecalis and 2,173 (40.5%) to E. faecium. The incidence of enterococcal bacteraemias increased by 3.2% per year (95% confidential interval (CI): 1.6–4.8%), predominantly due to a substantial increase in E. faecalis bacteraemic episodes. Vancomycin resistance affected 30 (1.4%) E. faecium and one E. faecalis bacteraemic episodes. Among all E. faecium bacteraemias, the proportion of vancomycin-resistant isolates increased steadily from 2013 to 2018 (2% per year; 95% CI: 1.5–2.9%). No independent epidemiological factor for higher prevalence of vancomycin-resistant E. faecium bacteraemias was identified. Conclusions Vancomycin-resistant E. faecium bacteraemias remain infrequent in Switzerland. However, an important increase was observed between 2013 and 2018, highlighting the need for implementing active surveillance and targeted prevention strategies in the country.

Run-off Patterns of Vancomycin Resistant Enterococci (VRE clones) in Cows Raw Milk and Imported Milk Powders at Baghdad Markets

2019 ◽  
Vol 43 (2) ◽  
pp. 61-66 ◽  
Author(s):  
Ali Hassan Ahmed Al-Shammary
Keyword(s):  
Enterococcus Faecalis ◽  
Raw Milk ◽  
Multidrug Resistant ◽  
Normal Flora ◽  
Milk Samples ◽  
Vancomycin Resistant Enterococci ◽  
Run Off ◽  
Vancomycin Resistant ◽  
Antibiotics Sensitivity ◽  
Contamination Events

Codebook shifting of some clones of Enterococci from normal flora to genotypically and phenotypically foodborne opportunistic and multidrug resistant pathogens in our ecosystem represent dangerous hygienic problem. Seventy-fivepooled milk samples were collectedfrom differentdistricts in Baghdad ecosystem from January until May (2019). Fiftyraw milk samples pooled directly from Cows and milk containers (twenty-five each) and twenty-five imported milk powders pooled from Baghdad markets in which, fifteen samples inspected monthly(five from each brand). Certifiedand modified traitsprofits for isolation and confirmation policy. Frequency and distribution of verified data in Baghdad environment reveled variable results. Seven Enterococcus faecalis phenotypes (9.33 %) recovered from raw milk samples in which, four isolates (5.33 %) recovered from Cows raw milk and three isolates (4 %) recovered from milk containers. None recovered clones founds in imported milk powders. All isolates were biofilm-producers and vancomycin resistant verifiedvia modified Christensen biofilm assay and antibiotics sensitivity test. Monitoring these contamination events with vancomycin resistant Enterococcus faecalis needs sophisticated hygienic efforts in Baghdad ecosystem

scholarly journals Comparison of the Rodac Imprint Method to Selective Enrichment Broth for Recovery of Vancomycin-Resistant Enterococci and Drug-Resistant Enterobacteriaceae from Environmental Surfaces

2000 ◽  
Vol 38 (12) ◽  
pp. 4646-4648 ◽  
Author(s):  
Donna M. Hacek ◽  
William E. Trick ◽  
Susan M. Collins ◽  
Gary A. Noskin ◽  
Lance R. Peterson
Keyword(s):  
Amphotericin B ◽  
Brain Heart Infusion ◽  
Multidrug Resistant ◽  
Drug Resistant ◽  
Enrichment Broth ◽  
Selective Enrichment ◽  
Vancomycin Resistant Enterococci ◽  
Environmental Surfaces ◽  
Vancomycin Resistant ◽  
Selective Enrichment Broth

We compared the Rodac imprint technique to selective enrichment broth for detecting vancomycin-resistant enterococci (VRE) and multidrug-resistant Enterobacteriaceae (MDRE) on surfaces. Rodac plates contained tryptic soy agar with 5% sheep blood, vancomycin (6 μg/ml), ceftazidime (2 μg/ml), amphotericin B (2 μg/ml), and clindamycin (1 μg/ml). Two types of broth were used: brain heart infusion (BHI) and BHI plus vancomycin (6 μg/ml) and ceftazidime (2 μg/ml) (BHIVC). Of the 46 surfaces cultured for VRE, 12 (26%) were positive. Of the 12 VRE-positive surfaces, 11 (92%) grew from Rodac, 8 (67%) grew from BHIVC, and 7 (58%) grew from BHI. A larger study is needed for MDRE, as only 4 of 43 surfaces were MDRE positive. The Rodac imprint technique successfully recovered VRE from environmental surfaces.

scholarly journals Vancomycin-Resistant Enterococci and Its Associated Risk Factors among HIV-Positive and -Negative Clients Attending Dessie Referral Hospital, Northeast Ethiopia

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Seid Ali ◽  
Martha Alemayehu ◽  
Mulat Dagnew ◽  
Teklay Gebrecherkos
Keyword(s):  
Risk Factors ◽  
Multidrug Resistant ◽  
Referral Hospital ◽  
Health Concern ◽  
Diffusion Method ◽  
Hiv Positive ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Associated Risk Factors ◽  
Dessie Referral Hospital

Background. Enterococci are becoming the most important public health concern and emerging as multidrug-resistant organisms around the world including Africa particularly in Ethiopia where there is a lack of availability of effective antimicrobial drugs. However, there is a paucity of data on the prevalence and associated risk factors of vancomycin-resistant enterococci in Ethiopia.Objective. This study was aimed to assess the prevalence of vancomycin-resistant enterococci and its associated risk factors among HIV-positive and -negative clients.Methods. A comparative cross-sectional study was conducted from February to May, 2017, on 300 participants at Dessie Referral Hospital. Data were gathered using a pretested structured questionnaire, stool samples were collected and inoculated on to bile esculin agar, and presumptive colonies were inoculated in brain-heart infusion broth containing 6.5% NaCl for selective identification of enterococci. Antibiotic susceptibility tests were done using the Kirby–Bauer disk diffusion method. Data were analyzed using SPSS version 22 software package.Results. A total of 300 study participants were enrolled in this study, of which 57.7% were females with a mean age of 34.4, a range of 19–73 years. The overall prevalence of enterococci was 37.3%. The prevalence of VRE was 6.3%. From all isolates, the prevalence of VRE among HIV-positive and -negative clients was 5.9% and 7.4%, respectively. Resistance gentamicin, ampicillin, penicillin, and erythromycin was 37.5%, 34.8%, 34.8%, and 22.3%, respectively. Prevalence of multidrug resistance was (29.5%). Being low in hemoglobin content was significantly associated with VRE.Conclusion. The high prevalence of VRE and multidrug-resistant enterococci in this study signals the emergence of VRE. Detection of VRE in this study indicates decreased antibiotic treatment options of multidrug-resistant enterococci. Therefore, there should be a need to perform continuous surveillance, rational use of antibiotics, and more detailed study using phenotypic and genotypic methods.

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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