Analysis of the molecular epidemiology and antibiotic sensitivity of vancomycin-resistant enterococci: Vankomisine dirençli enterokokların moleküler epidemiyolojisi ve antibiyotik duyarlılıklarının irdelenmesi

Yasemin Zer; Ayşen Bayram; Ebru Özgür Akın; İclal Balcı

doi:10.5455/GMJ-30-2011-36

Authors

Yasemin Zer University of Gaziantep, Faculty of Medicine, Department of Medical Microbiology, Gaziantep
Ayşen Bayram University of Gaziantep, Faculty of Medicine, Department of Medical Microbiology, Gaziantep
Ebru Özgür Akın Kilis State Hospital, Microbiology Laboratory, Kilis
İclal Balcı University of Gaziantep, Faculty of Medicine, Department of Medical Microbiology, Gaziantep

DOI:

https://doi.org/10.5455/GMJ-30-2011-36

Keywords:

Antibacterial susceptibility, enterococci, resistance gene, vancomycin

Abstract

Vancomycin-resistant Enterococci (VRE) are important nosocomial infection agents which have become widespread in recent years. The legal obligation to establish hospital infection control committees and increase in monitoring studies in Turkey has generalized VRE notifications. The treatment options for VRE-induced infections are limited. This study was conducted to identify the molecular epidemiology of the VRE sources found in the study hospital, and to determine the resistance of these strains to various antibiotics. The study was carried out on strains isolated in the microbiology laboratory of Şahinbey Research and Application Hospital, University of Gaziantep. Strains were identified at species level via conventional methods and a fully automated Vitek 2 (Biomerieux, France) identification system. Vancomycin sensitivity was tested via disc diffusion method and E-test (AB Biodisc) strips. Resistance genes of these strains were analyzed via PCR method using GeneOhm VanR (Becton Dickinson, Canada) moleculer tests. In vitro antibacterial efficiency of linezolid, dalfopristin, gentamicin, streptomycin and imipenem was analyzed via the disc diffusion method. All 81 strains included in the study were identified as Enterococcus faecium. VanA gene-type resistance was recorded in 76 (93.8%); vanB gene-type resistance in 2 (2.5%); and nonA-nonB type resistance in 3 (3.7%) of the study strains. No resistance was detected in any of the linezolid and dalfopristine strains. 75 VRE strains (92.6%) were found to be resistant to gentamicin, 28 strains (34.6%) to streptomycin and 79 strains (97.5%) to imipenem. Linezolid and dalfopristin were found to have complete in vitro efficiency against VRE strains, while these strains were found to be highly resistant to other antibiotics tested in the scope of the study. Since treatment of VRE-induced infections is relatively difficult, it is suggested that careful implementation of preventive measures is of great importance to patients in the fight against this agent.

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