Araştırma Makalesi
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Antibiotic susceptibility pattern of Enterococcus isolates in a five year period at a tertiary care hospital

Yıl 2019, Cilt: 3 Sayı: 9, 644 - 647, 01.09.2019
https://doi.org/10.28982/josam.612854

Öz

Aim: Enterococci are present as a part of the normal gut flora which can cause many community- and hospital-acquired infections. It is essential to determine the antibiotic resistance profile in treatment of Enterococcus spp. In this study we aimed to determine the sub-species of Enterococcus spp and their antibiotic resistance profiles isolated from a tertiary hospital in a five-year period.

Methods: The antibiotic resistance profiles of 2995 Enterococcus spp isolated from various clinical specimens of patients between January 2014 and December 2018 were reviewed in this retrospective cohort study. 

Results: Ampicillin resistance was very low (5.6%) in E. faecalis, but it was very high in E. faecium (91.8%). High level gentamycin, high level streptomycin and levofloxacin resistances were very high in all Enterococcus species and especially in E. faecium. Linezolid, tigecycline or daptomycin resistance was not determined in any Enterococcus isolates. Nitrofurantoin resistance (61.9%) and parenteral penicillin resistance (82.4%) were also very high in E. faecium isolates. Teicoplanin resistance was very low in E.faecalis (1.5%) isolates but approximately half (44.9%) of the E. faecium isolates were resistant to Teicoplanin. Vancomycin resistance was determined in 1.5% of E.faecalis isolates and in 45.5% of E. faecium isolates. 

Conclusion: In conclusion, we determined high resistance rates to many antibiotics in both E. faecalis and E. faecium isolates. Tigecyclin, linezolid and daptomycin resistance was not determined in any Enteroccus isolates. Vancomycin resistance was determined in 1.5% of E. faecalis isolates and in 45.5% of E. faecium isolates. This high rate of vancomycin resistance should be taken into account and studies should be conducted to eliminate this resistance.

Kaynakça

  • 1. Sood S, Malhotra M, Das BK, Kapil A. Enterococcal infections antimicrobial resistance. Indian J Med Res. 2008;128(2):111-21.
  • 2. Cheah ALY, Spelman T, Liew D. Peel T, Howden BP, D. Spelman, et al. Enterococcal bacteraemia: Factors influencing mortality, length of stay and costs of hospitalization Clin Microbiol Infect Year: 2013;19(4):E181-9.
  • 3. Bayjanov JR, Baan J, Rogers MRC, Troelstra A, Willems RJL, van Schaik W. Enterococcus faecium genome dynamics during long-term asymptomatic patient gut colonization. Microb Genom. 2019;5(7): e000277.
  • 4. Arias CA, Contreras GA, Murray BE. Management of multidrug-resistant enterococcal infections. Clin Microbiol Infect. 2010;16(6):555-62.
  • 5. Kang ZZ, Lei CW, Kong LH, Wang YL, Ye XL, Ma BH, at al. Detection of transferable oxazolidinone resistance determinants in enterococcus faecalis and enterococcus faecium of swine origin in Sichuan Province, China. J Glob Antimicrob Resist. 2019;25: doi: 10.1016/j.jgar.2019.05.021.
  • 6. EUCAST. EUCAST Clinical Breakpoint Table Version 6.0, Valid From 2016-01-01. Basel: EUCAST, 2016. http://www.eucast.org/clinical_breakpoints/.
  • 7. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. Twenty-fourth informational supplement update. CLSI document M100-S24. Clinical and Laboratory Standards Institute, Wayne, PA (2014).
  • 8. Karna A, Baral R, Khanal B. Characterization of clinical isolates of enterococci with special reference to glycopeptide susceptibility at a tertiary care center of Eastern Nepal. Int J Microbiol. 2019;7936156.
  • 9. Sattari-Maraji A, Jabalameli F, Node Farahani N, Beigverdi R, Emaneini M. Antimicrobial resistance pattern, virulence determinants and molecular analysis of enterococcus faecium isolated from children infections in Iran. BMC Microbiol. 2019;19(1):156.
  • 10. Liu C, Yoon EJ, Kim D, Shin JH, Shin JH, Shin KS, et al. Antimicrobial resistance in South Korea: A report from the Korean global antimicrobial resistance surveillance system (Kor-GLASS) for 2017. J Infect Chemother. 2019; pii: S1341-321X(19)30197-7.
  • 11. Mamtora D, Saseedharan S, Bhalekar P, Katakdhond S. Microbiological profile and antibiotic susceptibility pattern of Gram-positive isolates at a tertiary care hospital. J Lab Physicians. 2019;11(2):144-8.
  • 12. Zalipour M, Esfahani BN, Havaei SA. Phenotypic and genotypic characterization of glycopeptide, aminoglycoside and macrolide resistance among clinical isolates of Enterococcus faecalis: a multicenter based study. BMC Res Notes. 2019;12(1):292.
  • 13. Unal N, Askar S, Yıldırım M. Antibiotic resistance profile of Enterococcus faecium and enterococcus faecalis isolated from broiler cloacal samples. Turk J Vet Anim Sci. 2017;41:199-203.
  • 14. Asadollahi P, Razavi SH, Asadollahi KH, Pourshafie MR, Talebi M. Rise of antibiotic resistance in clinical enterococcal isolates during 2001-2016 in Iran: a review. New Microbes New Infect. 2018;26:92–9.
  • 15. Huang L, Zhang R, Hu Y, Zhou H, Cao J, Lv H, et al. Epidemiology and risk factors of methicillin-resistant staphylococcus aureus and vancomycin-resistant enterococci infections in Zhejiang China from 2015 to 2017. Antimicrob Resist Infect Control. 2019;30:8:90.
  • 16. Praharaj I, Sujatha S, Parija SC. Phenotypic & genotypic characterization of vancomycin resistant enterococcus isolates from clinical specimens. Indian J Med Res. 2013;138(4):549-56.
  • 17. Matheeussen V, Loens K, Scott C, Di Lorenzo C, McCulloch E, Donoso et al. Quality of molecular detection of vancomycin resistance in enterococci: results of 6 consecutive years of Quality Control for Molecular Diagnostics (QCMD) external quality assessment. Eur J Clin Microbiol Infect Dis. 2019;28:doi:10.1007/s10096-019-03591-2.
  • 18. Kumar S, Bandyoapdhyay M, Chatterjee M, Mukhopadhyay P, Poddar S, Banerjee P. The first linezolid-resistant Enterococcus faecium in India: High level resistance in a patient with no previous antibiotic exposure. Avicenna J Med. 2014;4(1):13-6.
  • 19. Kumar N, Agrawal SK, Govindaswamy A, Bajpai V, Bahadur T. Linezolid-resistant enterococcus faecalis in leukemia patients: Rare cases with review of literature. J Family Med Prim Care. 2019;8(4):1508-10.
  • 20. Levitus M, Perera TB. Vancomycin-Resistant Enterococci (VRE). Stat Pearls [Internet]. Treasure Island (FL): Stat Pearls Publishing; 2019.
  • 21. Lee T, Pang S, Abraham S, Coombs GW. Antimicrobial-resistant CC17 Enterococcus faecium: The past, the present and the future. J Glob Antimicrob Resist. 2018;16:36-47.

Üçüncü basamak bir hastanede beş yıllık bir sürede izole edilen Enterococcus izolatlarında antibiyotik duyarlılık profili

Yıl 2019, Cilt: 3 Sayı: 9, 644 - 647, 01.09.2019
https://doi.org/10.28982/josam.612854

Öz

Amaç: Enterokoklar, normal bağırsak florasının bir üyesi olup, birçok toplum- ve hastane- kökenli enfeksiyona neden olabilmektedirler. Enterococcus spp. tedavisinde antibiyotik direnç profilinin belirlenmesi son derece önemlidir. Bu çalışmanın amacı, beş yıllık bir süre içerisinde üçüncü basamak bir hastaneden izole edilen Enterococcus spp. alt tiplerini ve antibiyotik direnç profillerini belirlemektir.

Yöntemler: Ocak 2014-Aralık 2018 tarihleri arasında çeşitli klinik örneklerden izole edilen 2995 Enterococcus spp. nin antibiyotik direnç profilleri bu retrospektif kohort çalışmada incelendi.

Bulgular: E. faecalis 'te ampisilin direnci çok düşük (%5,6) iken E. faecium 'da (%91,8) çok yüksekti. Yüksek düzey gentamisin, yüksek düzey streptomisin ve levofloksasin dirençleri tüm Enterococcus türlerinde ve özellikle E. faecium 'da çok yüksekdi. Enterococcus izolatlarında linezolid, tigesiklin veya daptomisin direnci saptanmadı. E. faecium izolatlarında nitrofurantoin (%61,9) ve parenteral penisilin direnci (%82,4) de yüksekti. E. faecalis'te (%1,5) teicoplanin direnci çok düşüktü, ancak E. faecium izolatlarının yaklaşık yarısı (%44,9) teicoplanine dirençliydi. Vankomisin direnci, E. faecalis izolatlarının %1,5'inde, ancak E. faecium izolatlarının %45.5'inde belirlenmiştir.

Sonuç: Sonuç olarak, hem E. faecalis hem de E. faecium izolatlarında birçok antibiyotiğe yüksek direnç oranları belirledik. Enteroccus izolatlarında tigesiklin, linezolid ve daptomisin direnci yoktu. Vankomisin direnci, E. faecalis izolatlarının %1,5'inde, ancak E. faecium izolatlarının %45,5'inde belirlenmiştir. Bu yüksek vankomisin direnci oranı göz önünde bulundurularak bu direnci ortadan kaldırmak için çalışmalar yapılmalıdır.

Kaynakça

  • 1. Sood S, Malhotra M, Das BK, Kapil A. Enterococcal infections antimicrobial resistance. Indian J Med Res. 2008;128(2):111-21.
  • 2. Cheah ALY, Spelman T, Liew D. Peel T, Howden BP, D. Spelman, et al. Enterococcal bacteraemia: Factors influencing mortality, length of stay and costs of hospitalization Clin Microbiol Infect Year: 2013;19(4):E181-9.
  • 3. Bayjanov JR, Baan J, Rogers MRC, Troelstra A, Willems RJL, van Schaik W. Enterococcus faecium genome dynamics during long-term asymptomatic patient gut colonization. Microb Genom. 2019;5(7): e000277.
  • 4. Arias CA, Contreras GA, Murray BE. Management of multidrug-resistant enterococcal infections. Clin Microbiol Infect. 2010;16(6):555-62.
  • 5. Kang ZZ, Lei CW, Kong LH, Wang YL, Ye XL, Ma BH, at al. Detection of transferable oxazolidinone resistance determinants in enterococcus faecalis and enterococcus faecium of swine origin in Sichuan Province, China. J Glob Antimicrob Resist. 2019;25: doi: 10.1016/j.jgar.2019.05.021.
  • 6. EUCAST. EUCAST Clinical Breakpoint Table Version 6.0, Valid From 2016-01-01. Basel: EUCAST, 2016. http://www.eucast.org/clinical_breakpoints/.
  • 7. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. Twenty-fourth informational supplement update. CLSI document M100-S24. Clinical and Laboratory Standards Institute, Wayne, PA (2014).
  • 8. Karna A, Baral R, Khanal B. Characterization of clinical isolates of enterococci with special reference to glycopeptide susceptibility at a tertiary care center of Eastern Nepal. Int J Microbiol. 2019;7936156.
  • 9. Sattari-Maraji A, Jabalameli F, Node Farahani N, Beigverdi R, Emaneini M. Antimicrobial resistance pattern, virulence determinants and molecular analysis of enterococcus faecium isolated from children infections in Iran. BMC Microbiol. 2019;19(1):156.
  • 10. Liu C, Yoon EJ, Kim D, Shin JH, Shin JH, Shin KS, et al. Antimicrobial resistance in South Korea: A report from the Korean global antimicrobial resistance surveillance system (Kor-GLASS) for 2017. J Infect Chemother. 2019; pii: S1341-321X(19)30197-7.
  • 11. Mamtora D, Saseedharan S, Bhalekar P, Katakdhond S. Microbiological profile and antibiotic susceptibility pattern of Gram-positive isolates at a tertiary care hospital. J Lab Physicians. 2019;11(2):144-8.
  • 12. Zalipour M, Esfahani BN, Havaei SA. Phenotypic and genotypic characterization of glycopeptide, aminoglycoside and macrolide resistance among clinical isolates of Enterococcus faecalis: a multicenter based study. BMC Res Notes. 2019;12(1):292.
  • 13. Unal N, Askar S, Yıldırım M. Antibiotic resistance profile of Enterococcus faecium and enterococcus faecalis isolated from broiler cloacal samples. Turk J Vet Anim Sci. 2017;41:199-203.
  • 14. Asadollahi P, Razavi SH, Asadollahi KH, Pourshafie MR, Talebi M. Rise of antibiotic resistance in clinical enterococcal isolates during 2001-2016 in Iran: a review. New Microbes New Infect. 2018;26:92–9.
  • 15. Huang L, Zhang R, Hu Y, Zhou H, Cao J, Lv H, et al. Epidemiology and risk factors of methicillin-resistant staphylococcus aureus and vancomycin-resistant enterococci infections in Zhejiang China from 2015 to 2017. Antimicrob Resist Infect Control. 2019;30:8:90.
  • 16. Praharaj I, Sujatha S, Parija SC. Phenotypic & genotypic characterization of vancomycin resistant enterococcus isolates from clinical specimens. Indian J Med Res. 2013;138(4):549-56.
  • 17. Matheeussen V, Loens K, Scott C, Di Lorenzo C, McCulloch E, Donoso et al. Quality of molecular detection of vancomycin resistance in enterococci: results of 6 consecutive years of Quality Control for Molecular Diagnostics (QCMD) external quality assessment. Eur J Clin Microbiol Infect Dis. 2019;28:doi:10.1007/s10096-019-03591-2.
  • 18. Kumar S, Bandyoapdhyay M, Chatterjee M, Mukhopadhyay P, Poddar S, Banerjee P. The first linezolid-resistant Enterococcus faecium in India: High level resistance in a patient with no previous antibiotic exposure. Avicenna J Med. 2014;4(1):13-6.
  • 19. Kumar N, Agrawal SK, Govindaswamy A, Bajpai V, Bahadur T. Linezolid-resistant enterococcus faecalis in leukemia patients: Rare cases with review of literature. J Family Med Prim Care. 2019;8(4):1508-10.
  • 20. Levitus M, Perera TB. Vancomycin-Resistant Enterococci (VRE). Stat Pearls [Internet]. Treasure Island (FL): Stat Pearls Publishing; 2019.
  • 21. Lee T, Pang S, Abraham S, Coombs GW. Antimicrobial-resistant CC17 Enterococcus faecium: The past, the present and the future. J Glob Antimicrob Resist. 2018;16:36-47.
Toplam 21 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Tıbbi Mikrobiyoloji
Bölüm Araştırma makalesi
Yazarlar

Orkide Kutlu 0000-0002-4402-2231

Çiğdem Arabacı 0000-0003-0050-3225

Yayımlanma Tarihi 1 Eylül 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 3 Sayı: 9

Kaynak Göster

APA Kutlu, O., & Arabacı, Ç. (2019). Antibiotic susceptibility pattern of Enterococcus isolates in a five year period at a tertiary care hospital. Journal of Surgery and Medicine, 3(9), 644-647. https://doi.org/10.28982/josam.612854
AMA Kutlu O, Arabacı Ç. Antibiotic susceptibility pattern of Enterococcus isolates in a five year period at a tertiary care hospital. J Surg Med. Eylül 2019;3(9):644-647. doi:10.28982/josam.612854
Chicago Kutlu, Orkide, ve Çiğdem Arabacı. “Antibiotic Susceptibility Pattern of Enterococcus Isolates in a Five Year Period at a Tertiary Care Hospital”. Journal of Surgery and Medicine 3, sy. 9 (Eylül 2019): 644-47. https://doi.org/10.28982/josam.612854.
EndNote Kutlu O, Arabacı Ç (01 Eylül 2019) Antibiotic susceptibility pattern of Enterococcus isolates in a five year period at a tertiary care hospital. Journal of Surgery and Medicine 3 9 644–647.
IEEE O. Kutlu ve Ç. Arabacı, “Antibiotic susceptibility pattern of Enterococcus isolates in a five year period at a tertiary care hospital”, J Surg Med, c. 3, sy. 9, ss. 644–647, 2019, doi: 10.28982/josam.612854.
ISNAD Kutlu, Orkide - Arabacı, Çiğdem. “Antibiotic Susceptibility Pattern of Enterococcus Isolates in a Five Year Period at a Tertiary Care Hospital”. Journal of Surgery and Medicine 3/9 (Eylül 2019), 644-647. https://doi.org/10.28982/josam.612854.
JAMA Kutlu O, Arabacı Ç. Antibiotic susceptibility pattern of Enterococcus isolates in a five year period at a tertiary care hospital. J Surg Med. 2019;3:644–647.
MLA Kutlu, Orkide ve Çiğdem Arabacı. “Antibiotic Susceptibility Pattern of Enterococcus Isolates in a Five Year Period at a Tertiary Care Hospital”. Journal of Surgery and Medicine, c. 3, sy. 9, 2019, ss. 644-7, doi:10.28982/josam.612854.
Vancouver Kutlu O, Arabacı Ç. Antibiotic susceptibility pattern of Enterococcus isolates in a five year period at a tertiary care hospital. J Surg Med. 2019;3(9):644-7.