伊朗西北部住院患者分离肠球菌的毒力决定因素、氨基糖苷类和万古霉素耐药率较高。
High incidence of virulence determinants, aminoglycoside and vancomycin resistance in enterococci isolated from hospitalized patients in Northwest Iran.
机构信息
Department of Microbiology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
Zanjan Pharmaceutical Biotechnology Research Center, Zanjan University of Medical Sciences, Zanjan, Iran.
出版信息
BMC Infect Dis. 2019 Aug 27;19(1):744. doi: 10.1186/s12879-019-4395-3.
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.
背景
多药耐药（MDR）肠球菌是引起住院患者严重问题的重要医院病原体。本研究的目的是调查从住院患者尿路感染分离的肠球菌中高水平氨基糖苷类耐药和万古霉素耐药肠球菌（VRE）以及毒力编码基因的频率。
方法
共检测了 100 株来自有症状尿路感染住院患者尿液样本中的肠球菌对 10 种抗菌药物的药敏性、氨基糖苷类和万古霉素耐药基因（包括 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 和 vanC）和毒力编码基因（包括 gelE、PAI、esp、ace、cyl、hyl 和 sprE）的频率。
结果
肠球菌属中以粪肠球菌为主（69%），其次是“其他”肠球菌属（21%）和屎肠球菌（10%）。93%的分离株对一种或多种抗菌药物耐药，最常见的耐药性为四环素（86%）、环丙沙星（73%）和奎奴普丁/达福普汀（53%）。庆大霉素和链霉素耐药分别在 50%和 34%的分离株中检测到。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。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，屎肠球菌中庆大霉素耐药和 VRE 的频率较高，毒力和耐药基因的流行率和异质性较高。由于多药耐药肠球菌的高频率，似乎需要采取适当的监测和控制措施，以防止这些分离株在医院中的出现和传播。
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