RESUMO
We aimed to characterize the vancomycin genotype/phenotype, carriage of putative virulence genes, and genetic relatedness of Enterococcus faecium isolates in Saudi Arabia. E. faecium isolated from inpatients at our medical center were studied. Sensitivity to ampicillin, linezolid, teicoplanin, quinupristin/dalfopristin, tetracycline, and ciprofloxacin was determined. The presence of van genes and virulence genes for aggregation substance (Asa-1), enterococcal surface proteins (esp), cytolysin (cylA, cylL, cylM), gelatinase (gelE), E. faecium endocarditis antigen (EfaA( fm )), hyaluronidase (hyl), and collagen adhesion (Ace) was assessed. Genetic relatedness was determined by pulsed-field gel electrophoresis (PFGE). Twenty-nine E. faecium isolates were obtained and the majority of isolates (n/N = 22/29) were from stool specimens. PFGE analysis identified eight pulsotypes (A-H) based on 80 % similarities. Isolates were represented in five major pulsotypes: type A (n = 5), type B (n = 3), type D (n = 6), type E (n = 5), and type F (n = 7). All isolates were vanA gene-positive. Thirteen isolates had vanA(+)/vanB(+) genotype. Of these, ten exhibited a vanB phenotype and three had a vanA phenotype. Eight isolates with vanA(+)/vanB(-) genotype exhibited vanB phenotype. Six of these eight isolates belonged to the same pulsotype. All isolates were positive for gelE, esp, and EfaA( fm ) genes. Five were CylA-positive and 24 had the hyl genes. Of the eight isolates harboring a combination of gelE, esp, EfaA( fm ), and hyl genes, five showed vanB phenotype-vanA genotype incongruence. This is the first report of vanB phenotype-vanA genotype incongruent E. faecium in the Middle East region. Molecular typing indicates clonal spread and high occurrence of virulence genes, especially esp genes, associated with epidemic clones.
Assuntos
Proteínas de Bactérias/genética , Carbono-Oxigênio Ligases/genética , Enterococcus faecium/efeitos dos fármacos , Enterococcus faecium/isolamento & purificação , Resistência a Vancomicina , Centros Médicos Acadêmicos , Proteínas de Bactérias/metabolismo , Carbono-Oxigênio Ligases/metabolismo , Análise por Conglomerados , DNA Bacteriano/genética , Eletroforese em Gel de Campo Pulsado , Enterococcus faecium/classificação , Enterococcus faecium/genética , Fezes/microbiologia , Genótipo , Infecções por Bactérias Gram-Positivas/microbiologia , Humanos , Tipagem Molecular , Fenótipo , Arábia Saudita , Fatores de Virulência/genéticaRESUMO
The study aimed to determine hospital-based prevalence of vertebral fractures in postmenopausal Saudi Arabian women. Chest radiographs from consecutive Saudi women over the age of 50 years visiting the emergency room at King Fahd Hospital of the University were evaluated. Of 785 radiographs analysed 159 (20.3%) patients had 198 vertebral fractures. The mean age of the women was 65.7 (SD 8.5) years. In only 37.8% of the radiographs with fractures was a vertebral fracture highlighted in the radiologist's report, and only 13.2% of the women with vertebral fractures were on antiresorptive therapy for osteoporosis.
Assuntos
Fraturas Espontâneas/epidemiologia , Fraturas Espontâneas/etiologia , Osteoporose Pós-Menopausa/complicações , Fraturas da Coluna Vertebral/epidemiologia , Fraturas da Coluna Vertebral/etiologia , Vértebras Torácicas/lesões , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Precoce , Serviço Hospitalar de Emergência , Feminino , Fraturas Espontâneas/diagnóstico por imagem , Hospitais Universitários , Humanos , Pacientes Internados/estatística & dados numéricos , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/tratamento farmacológico , Pós-Menopausa , Prevalência , Radiografia , Estudos Retrospectivos , Arábia Saudita/epidemiologia , Distribuição por Sexo , Fraturas da Coluna Vertebral/diagnóstico por imagemRESUMO
The study aimed to determine hospital-based prevalence of vertebral fractures in postmenopausal Saudi Arabian women. Chest radiographs from consecutive Saudi women over the age of 50 years visiting the emergency room at King Fahd Hospital of the University were evaluated. Of 785 radiographs analysed 159 [20.3%] patients had 198 vertebral fractures. The mean age of the women was 65.7 [SD 8.5] years. In only 37.8% of the radiographs with fractures was a vertebral fracture highlighted in the radiologist's report, and only 13.2% of the women with vertebral fractures were on antiresorptive therapy for osteoporosis
