High incidence of virulence determinants, aminoglycoside and vancomycin resistance in enterococci isolated from hospitalized patients in Northwest Iran
High incidence of virulence determinants, aminoglycoside and vancomycin resistance in enterococci isolated from hospitalized patients in Northwest Iran
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DOI：
10.1186/s12879-019-4395-3
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发表时间：
2019-08-27
影响因子：
3.7
通讯作者：
Zeighami, Habib
中科院分区：
文献类型：
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作者：
Haghi, Fakhri;Lohrasbi, Vahid;Zeighami, Habib
背景：多重耐药（MDR）肠球菌是重要的医院病原体，对住院患者造成严重问题。本研究的目的是调查住院患者分离的肠球菌中高水平氨基糖苷类耐药和万古霉素耐药的肠球菌（VRE）频率以及毒力编码基因。方法：对100株有症状尿路感染的住院患者尿样中分离的肠球菌进行药敏、氨基糖苷类和万古霉素耐药基因（包括aac（6）-Ie-aph（2）频率）的检测。 '')-Ia、aph (3')-IIIa、ant (4')-Ia、aph (2'')-Ic、aph (2'')-Ib、aph (2'')-Id、ant (3'')-III、ant (6)-Ia、vanA、vanB 和 vanC) 和毒力编码基因（包括 gelE、PAI、esp、ace、cyl、hyl结果：粪肠球菌被确定为主要肠球菌 (69%)，其次是其他肠球菌 (21%) 和屎肠球菌 (10%)。 93% 的分离株对一种或多种抗菌药物具有耐药性，其中最常见的是对四环素 (86%)、环丙沙星 (73%) 和奎奴普汀-达福普汀 (53%) 耐药。分别在 50% 和 34% 的分离株中检测到庆大霉素和链霉素耐药性。最常见的氨基糖苷类耐药基因是ant (3'')-III (78%) 和aph (3')-IIIa (67%)。 21% 的分离株检测到万古霉素耐药性。所有屎肠球菌分离株均携带 vanA 基因，而肠球菌属中未检测到 vanB 基因。最常见的毒力基因是 ace (88.6%)，其次是 esp (67.1%)、PAI (45.5%) 和 sprE (41.7%)。 结论：我们的研究表明，屎肠球菌分离株中庆大霉素耐药性和 VRE 发生率较高，且毒力和耐药基因的流行率和异质性较高。由于耐多药肠球菌的发生率很高，因此采取适当的监测和控制措施对于防止这些菌株在医院中的出现和传播至关重要。
Background: Multidrug resistant (MDR) enterococci are important nosocomial pathogens causing serious problem in hospitalized patients. The aim of present study was to investigate the frequency of high-level aminoglycoside-resistant and vancomycin-resistant enterococci (VRE) and virulence encoding genes in enterococci isolated from hospitalized patients.Methods: A total of 100 enterococci isolated from urine samples of hospitalized patients with symptomatic urinary tract infections were investigated for antimicrobial susceptibility, the frequency of aminoglycoside and vancomycin resistance genes (including aac (6)-Ie-aph (2 '')-Ia, aph (3')-IIIa, ant (4')-Ia, aph (2 '')-Ic, aph (2 '')-Ib, aph (2 '')-Id, ant (3 '')-III, ant (6)-Ia, vanA, vanB and vanC) and virulence encoding genes (including gelE, PAI, esp, ace, cyl, hyl and sprE).Results: Enterococcus faecalis species was identified as predominant enterococci (69%), followed by other Enterococcus species (21%) and E. faecium (10%). Ninety three percent of isolates were resistant to one or more antimicrobial agents, with the most frequent resistance found against tetracycline (86%), ciprofloxacin (73%) and quinupristin-dalfopristin (53%). Gentamicin and streptomycin resistance were detected in 50 and 34% of isolates, respectively. The most prevalent aminoglycoside resistance genes were ant (3 '')-III (78%) and aph (3 ')-IIIa (67%). Vancomycin resistance was detected in 21% of isolates. All E. faecium isolates carried vanA gene, whereas, the vanB gene was not detected in Enterococcus species. The most frequent virulence gene was ace (88.6%), followed by esp (67.1%), PAI (45.5%) and sprE (41.7%).Conclusion: Our study revealed the high frequency of gentamycin resistance and VRE in E. faecium isolates, with a high prevalence and heterogeneity of virulence and resistance genes. Due to high frequency of MDR enterococci, it seems that the appropriate surveillance and control measures are essential to prevent the emergence and transmission of these isolates in hospitals.