Clinically Relevant Enterococcus Species and PCR Screening of Antibiotic Resistance and Virulence Factor Coding Genes
Life Sciences-Microbiology
DOI:
https://doi.org/10.22376/ijpbs/lpr.2022.12.2.L101-110Keywords:
Enterococci, Multi drug resistance, Genotyping, Nosocomial infections, VREAbstract
Enterococci are Gram positive cocci which are common residence of gastro intestinal tracts of humans and animals. But they are capable of causing severe infections, most often in hospitalised patients. Enterococci are important nosocomial pathogens and their intrinsic property of antibiotic resistance makes treatment difficult. Against this clinical significance, a study was conducted on the prevalence of vancomycin resistant enterococcal infections and their antibiotic sensitivity patterns at Sunrise Institute of Medical Sciences, a tertiary care hospital in Kochi, Kerala state. Various clinical specimens like blood, urine, abscess, vaginal swab etc. were microbiologically screened for the presence of antibiotic resistant Enterococci. The common phenotyping methods and genotyping protocols were used to identify the species for the study. The vancomycin resistant strains were typed genotypically by using 16S rDNA sequencing and the isolates were speciated to be E. faecium. A molecular screening of the isolates was also done for the presence of various virulence factor coding genes and for the genes which confer antibiotic resistance. The findings of the study revealed that 89.1 % isolated strains were multidrug resistant and a total of 4 antibiotic resistance genes were detected. Among the isolates the vancomycin resistance genes vanA, vanB; tetracycline resistance genes tetA and macrolide resistance gene ermA were screened. The presence of genes coding for various virulence factors were also detected among the isolates. However, we present an overview of antibiotic resistance pattern and virulence factors present in enterococci and we strongly believe that these results will surely help to design a new disinfection regime and antibiotic stewardship to control the incidence of infection.
References
Arias, C. A. & Murray, B. E. The rise of the Enterococcus: beyond vancomycin resistance. Nat.Rev. Microbiol. 10, 266–278 (2012).
Lebreton, F., Willems, R. J. L. & Gilmore, M. S. Enterococcus Diversity, Origins in Nature, and Gut Colonization. in Enterococci: From Commensals to Leading Causes of Drug Resistant Infection (eds. Gilmore, M. S., Clewell, D. B., Ike, Y. & Shankar, N.) (Massachusetts Eye and Ear Infirmary, 2014).
Sghir, A. et al. Quantification of Bacterial Groups within Human Fecal Flora by Oligonucleotide Probe Hybridization. Appl. Environ. Microbiol. 66, 2263–2266 (2000).
Eliopoulos, G. M. 1993. Increasing problems in the therapy of enterococcal infections. Eur. J. Clin. Microbiol. Infect. Dis. 12:409–412.
Moellering, R. C., Jr. 1992. Emergence of Enterococcus as a significant pathogen. Clin. Infect. Dis. 14:1173–1176.
Weiner LM, Webb AK, Limbago B, Dudeck MA, Patel J, Kallen AJ, Edwards JR, Sievert DM. 2016. Antimicrobial-Resistant Pathogens Associated With Healthcare-Associated Infections: Summary of Data Reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2011-2014. Infect Control Hosp Epidemiol. 2016 Nov; 37(11):1288-1301.
Harrington.S.M.,Ross.T.L,Gebo.K.A. and Merz.W.G.2004. Vancomycin Resistance, esp, and Strain Relatedness: a 1 year study of Enterococcal Bacteremia. J.Clin. Microbiol, 42: 5895-5898.
G. S. Simonsen, L. Småbrekke, D. L. Monnet, T. L. Sørensen, J. K. Møller, K. G. Kristinsson, A. Lagerqvist- Widh, E. Torell, A. Digranes, S. Harthug, A. Sundsfjord, Prevalence of resistance to ampicillin, gentamicin and vancomycin in Enterococcus faecalis and Enterococcus faecium isolates from clinical specimens and use of antimicrobials in five Nordic hospitals, Journal of Antimicrobial Chemotherapy, Volume 51, Issue 2, February 2003, Pages 323–331,
Jayaratne.P and Rutherford.C. 1999. Detection of Clinically Relevant Genotypes of Vancomycin – Resistant Enterococci in Nosocomial Surveillance Specimens by PCR.J. Clin. Microbio. 37:2090- 2092.
Satake .S, Clark. N, Rimland.D, Nolte.F.S and Tenover.F.C. 1997. Detection of Vancomycin Resistant Enterococci in Fecal Samples by PCR. J. Clin. Microbio.35:2325-2330.
Annamiele, Bandera.M and Goldstein.B.P.1995. Use of primers Selective For Vancomycin Resistance Genes To Determine van Genotype in Enterococci and to study Gene organization in Van A isolates.Anti microbial agents and chemotherapy.39:1772-1778.
Kariyama.R, Mituhata.R, Chow.J.W,Clewell.D.B and Kumon.H 2000. Simple and Reliable Multiplex PCR Assay For Surveillance Isolates of Vancomycin- Resistant Enterococci. J. Clin. Microbio. 38:3092- 3095.
Centre for Disease Control and Prevention. 1995. Recommendations for preventing the spread of vancomycin resistance. Recommendations of the Hospital Infection Control Practice Advisory Committee (HICPAC). Morbid. Mortal. Weekly Rep. 44:1–13.
Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing; Twenty-fourth informational supplement M100-S24.Wayne: CLSI, 2014. Vol. 34 No. 1.
Humphries, R. M., Ambler, J., Mitchell, S. L., Castanheira, M., Dingle, T., Hindler, J. A., ...&Sei, K. (2018). CLSI methods development and standardization working group best practices for evaluation of antimicrobial susceptibility tests. Journal of clinical microbiology, 56(4).
Hombach, M., Mouttet, B., &Bloemberg, G. V. (2013). Consequences of revised CLSI and EUCAST guidelines for antibiotic susceptibility patterns of ESBL-and AmpC β-lactamase-producing clinical Enterobacteriaceae isolates. Journal of Antimicrobial Chemotherapy, 68(9), 2092-2098.
Cui, P., Feng, L., Zhang, L., He, J., An, T., Fu, X., ...& Yan, W. (2020). Antimicrobial Resistance, Virulence Genes, and Biofilm Formation Capacity Among Enterococcus species From Yaks in Aba Tibetan Autonomous Prefecture, China. Frontiers in microbiology, 11, 1250.
Facklam, R. R., and M. D. Collins. 1989. Identification of Enterococcus species isolated from human infections by a conventional test scheme. J. Clin. Microbiol. 27:731–734.
Mohanty, S., Jose, S., Singhal, R., Sood, S., Dhawan, B., Das, B. K., &Kapil, A. (2005). Species prevalence and antimicrobial susceptibility of enterococci isolated in a tertiary care hospital of North India. Southeast Asian journal of tropical medicine and public health, 36(4), 962.
Moemen, D., Tawfeek, D., &Badawy, W. (2015). Healthcare-associated vancomycin resistant Enterococcus faecium infections in the Mansoura University Hospitals intensive care units, Egypt. Brazilian Journal of Microbiology, 46(3), 777-783.
Sood, S., Malhotra, M., Das, B. K., &Kapil, A. (2008). Enterococcal infections & antimicrobial resistance. Indian Journal of Medical Research, 128(2), 111.
Abamecha, A., Wondafrash, B., &Abdissa, A. (2015). Antimicrobial resistance profile of Enterococcus species isolated from intestinal tracts of hospitalized patients in Jimma, Ethiopia. BMC research notes, 8(1), 213.
Kapoor, L., Randhawa, V. S., & Deb, M. (2005). Antimicrobial resistance of enterococcal blood isolates at a pediatric care hospital in India. Jpn J Infect Dis, 58(2), 101-3.
Kim, Y. B., Seo, K. W., Jeon, H. Y., Lim, S. K., Sung, H. W., & Lee, Y. J. (2019). Molecular characterization of erythromycin and tetracycline-resistant Enterococcus faecalis isolated from retail chicken meats. Poultry science, 98(2), 977-983.
Hao, W., Shan, X., Li, D., Schwarz, S., Zhang, S. M., Li, X. S., & Du, X. D. (2019). Analysis of a poxtA-and optrA-co-carrying conjugative multiresistance plasmid from Enterococcus faecalis. Journal of Antimicrobial Chemotherapy, 74(7), 1771-1775.
Lei, C. W., Kang, Z. Z., Wu, S. K., Chen, Y. P., Kong, L. H., & Wang, H. N. (2019). Detection of the phenicol–oxazolidinone–tetracycline resistance gene poxtA in Enterococcus faecium and Enterococcus faecalis of food-producing animal origin in China. Journal of Antimicrobial Chemotherapy, 74(8), 2459-2461.
Lim, S. Y., Teh, C. S. J., & Thong, K. L. (2017). Biofilm-related diseases and omics: global transcriptional profiling of Enterococcus faecium reveals different gene expression patterns in the biofilm and planktonic cells. OMICS: A Journal of Integrative Biology, 21(10), 592-602.
Kiruthiga, A., Padmavathy, K., Shabana, P., Naveenkumar, V., Gnanadesikan, S., &Malaiyan, J. (2020). Improved detection of esp, hyl, asa1, gelE, cylA virulence genes among clinical isolates of Enterococci. BMC Research Notes, 13(1), 1-7
Published
How to Cite
Issue
Section
Copyright (c) 2022 Jijo G Varghese, Anandharaj B, Fiji E

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

