Comparative Analysis of Prevalence and Antibiotic Resistance in Vancomycin-Resistant Enterococcus from Clinical Samples – Demographics and Phenotypes

Avicenna Journal of Clinical Microbiology and Infection Pub Date : 2021-06-29 DOI:10.34172/ajcmi.2021.11

F. Adeyemi, Nana-Aishat Yusuf, R. R. Adeboye, O. Oluwajide, A. K. Ako-Nai

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引用次数: 2

Abstract

Background: Of all enterococci species, the most renowned clinically as multidrug-resistant pathogens are Enterococcus faecium and Enterococcus faecalis. Vancomycin-resistant Enterococcus (VRE) species are the principal cause of opportunistic hospital-acquired infections, due to numerous resistance mechanisms. Methods: In this study, the prevalence and antibiotic resistance profiles of VRE according to clinical sources from three selected hospitals in Southwest-Nigeria were investigated. Altogether, 431 samples (urine, rectal, and wound swabs - caesarian section (CS), automobile accidents, and other skin lesions and abrasions) were collected from three selected hospitals in Osun State, Nigeria. Established techniques were employed for the recovery of enterococci and screening for VRE while antibiotic susceptibility tests were carried out by disc diffusion technique. Results: Altogether, 208 (48.3%) enterococci strains were recovered from which 85 (40.9%) were VRE. E. faecium predominated at 71.8% (61/85) and E. faecalis at 28.2% (24/85) as determined by phenotypic characterization. VRE isolates exhibited 100%, 97.6%, and 92.9% resistance to ampicillin, clindamycin, and quinupristin-dalfopristin (Q/D) respectively. The least resistance in-vitro was to tigecycline (27.1%). None of the antibiotics exhibited 100% activity against all the isolates. vanA resistant phenotype was prevalent at 65.9%. E. faecium from all study locations displayed higher levels of resistance than E. faecalis. Multiple antibiotic resistance (MAR) indices in all VRE isolates were ≥0.2, all being multidrug-resistant. Conclusions: The high prevalence rate along with the high level of multidrug resistance observed in the present study is worrisome and poses a continuous threat in the therapy of illnesses triggered by VRE as vancomycin was perceived as a drug of choice to curb enterococcal infections.

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临床样本中万古霉素耐药肠球菌患病率和耐药性的比较分析-人口统计学和表型

背景:在所有肠球菌种类中，临床上最著名的多重耐药病原体是屎肠球菌和粪肠球菌。万古霉素耐药肠球菌(VRE)物种是机会性医院获得性感染的主要原因，由于多种耐药机制。方法:选取尼日利亚西南部3家医院的临床资料，对VRE的流行情况和耐药性进行调查。总共从尼日利亚奥孙州选定的三家医院收集了431份样本(尿液、直肠和伤口拭子——剖腹产、车祸和其他皮肤损伤和擦伤)。采用已建立的方法进行肠球菌回收和VRE筛查，采用圆盘扩散法进行抗生素药敏试验。结果:共检获肠球菌208株(48.3%)，其中VRE 85株(40.9%);表型分析结果显示，粪肠杆菌占71.8%(61/85)，粪肠杆菌占28.2%(24/85)。VRE分离株对氨苄西林、克林霉素和奎努普司汀-达佛普司汀的耐药率分别为100%、97.6%和92.9% (Q/D)。体外耐药最少的是替加环素(27.1%)。没有一种抗生素对所有菌株都有100%的活性。抗vanA表型普遍存在，占65.9%。所有研究地点的粪肠杆菌均表现出比粪肠杆菌更高的耐药性。所有VRE分离株的多重耐药指数均≥0.2，均为多重耐药。结论:本研究中观察到的高患病率和高水平的多药耐药令人担忧，并对VRE引发的疾病的治疗构成持续威胁，因为万古霉素被认为是抑制肠球菌感染的首选药物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Avicenna Journal of Clinical Microbiology and Infection

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