ABSTRACT
ABSTRACT Vancomycin-resistant Enterococcus faecium (VREfm) has emerged as an important global nosocomial pathogen, and this trend is associated with the spread of high-risk clones. Here, we determined the genetic and phenotypic features of 93 VREfm isolates that were obtained from patients in 13 hospitals in Vitória, Espírito Santo, Brazil, during 2012-2013. All the isolates were vancomycin-resistant and harbored the vanA gene. Only 6 (6.5%) of the VREfm isolates showed the ability to form biofilm. The 93 isolates analyzed belong to a single pulsed-field gel electrophoresis lineage and presented six subtypes. MLST genotyping showed that all VREfm belonged to ST412 (the high-risk clone, hospital-adapted). The present study describes the dissemination of ST412 clone in the local hospitals. The clonal spread of these ST412 isolates in the area we analyzed as well as other hospitals in southeastern Brazil supports the importance of identifying and controlling the presence of these microorganisms in health care-related services.
Subject(s)
Humans , Cross Infection/microbiology , Gram-Positive Bacterial Infections/microbiology , Enterococcus faecium/genetics , Vancomycin-Resistant Enterococci/genetics , Bacterial Proteins , Brazil , Microbial Sensitivity Tests , Bacterial Typing Techniques , Enterococcus faecium/drug effects , Electrophoresis, Gel, Pulsed-Field , Multilocus Sequence Typing , Vancomycin-Resistant Enterococci/drug effects , Anti-Bacterial Agents/pharmacologyABSTRACT
ABSTRACT Rapid identification of vancomycin-resistant enterococci (VRE) can assist in choosing the appropriate treatment and preventing VRE spread. The performance of chromIDTM VRE agar was evaluated using 184 clinical isolates of Enterococcus spp. and reference strains. The test had a sensitivity of 95.52% but a low specificity of 30%.
Subject(s)
Humans , Bacteriological Techniques/methods , Gram-Positive Bacterial Infections/microbiology , Culture Media/chemistry , Vancomycin-Resistant Enterococci/growth & development , Vancomycin-Resistant Enterococci/drug effects , Microbial Sensitivity Tests , Bacteriological Techniques/instrumentation , Culture Media/metabolism , Feces/microbiology , Vancomycin-Resistant Enterococci/metabolismABSTRACT
Abstract The aim of this study was to determine the association between Clostridium difficile (C. difficile) and vancomycin-resistant Enterococcus (VRE) and efficacy of screening stools submitted for C. difficile toxin assay for prevalence of VRE. Between April 2012 and February 2014, 158 stool samples submitted for C. difficile toxin to the Marmara University Microbiology Laboratory, were included in the study. Stool samples were analyzed by enzyme immuno assay test; VIDAS (bioMerieux, France) for Toxin A&B. Samples were inoculated on chromID VRE (bioMerieux, France) and incubated 24 h at 37 °C. Manuel tests and API20 STREP (bioMerieux, France) test were used to identify the Enterococci species. After the species identification, vancomycin and teicoplanin MIC's were performed by E test and molecular resistance genes for vanA vs vanB were detected by polymerase chain reaction (PCR). Of the 158 stool samples, 88 were toxin positive. The prevalence of VRE was 17%(n:19) in toxin positives however, 11.4% in toxin negatives(n:70). All VRE isolates were identified as Enterococcus faecium. These results were evaluated according to Fischer's exact chi-square test and p value between VRE colonization and C. difficile toxin positivity was detected 0.047 (p < 0.05). PPV and NPV were 79% and 47% respectively. In our study, the presence of VRE in C. difficile toxin positives is statistically significant compared with toxin negatives (p < 0.05). Screening for VRE is both additional cost and work load for the laboratories. Therefore VRE screening among C. difficile toxin positive samples, will be cost effective for determination of high risk patients in the hospitals especially for developing countries.
Subject(s)
Humans , Bacterial Toxins/analysis , Clostridioides difficile/metabolism , Clostridium Infections/microbiology , Vancomycin Resistance , Feces/microbiology , Vancomycin-Resistant Enterococci/isolation & purification , Bacterial Toxins/metabolism , Vancomycin/pharmacology , Microbial Sensitivity Tests , Clostridioides difficile/isolation & purification , Clostridioides difficile/drug effects , Clostridioides difficile/genetics , Gram-Positive Bacterial Infections/diagnosis , Gram-Positive Bacterial Infections/microbiology , Clostridium Infections/diagnosis , Vancomycin-Resistant Enterococci/classification , Vancomycin-Resistant Enterococci/drug effects , Vancomycin-Resistant Enterococci/genetics , Anti-Bacterial Agents/pharmacologyABSTRACT
Vancomycin resistant
Subject(s)
Humans , Anti-Bacterial Agents/therapeutic use , Cross Infection/epidemiology , Enterococcus faecium/drug effects , Gram-Positive Bacterial Infections/epidemiology , Vancomycin Resistance/physiology , Vancomycin-Resistant Enterococci/isolation & purification , Vancomycin/therapeutic use , Cephalosporins/therapeutic use , Ciprofloxacin/therapeutic use , Cross Infection/microbiology , DNA, Bacterial/genetics , Egypt/epidemiology , Enterococcus faecium/isolation & purification , Gentamicins/therapeutic use , Gram-Positive Bacterial Infections/drug therapy , Gram-Positive Bacterial Infections/microbiology , Intensive Care Units , Infection Control/methods , Microbial Sensitivity Tests , Prospective Studies , Renal Insufficiency , Risk Factors , Vancomycin-Resistant Enterococci/drug effectsABSTRACT
Twenty seven isolates of vancomycin resistant Enterococci based on the disk diffusion and E- test have been screened; being found eight (0.3%) clinical isolates of vanA & vanB through Taq Man Real Time PCR assay. This study shows the presence of both vanA & vanB genotypes in vanA phenotypes clinical isolates in the three hospitals in Iran.