Chakrabarti Ankan, Bhattacharya Sibabrata, Pratap Datta Rana, Majumdar Tapan
Medical Research Scientist, Department of Microbiology Department of Microbiology, AGMC & GBP Hospital, P.O. Kunjavan, Agartala, West Tripura, 799006, India.
Associate Professor, Department of Microbiology Department of Microbiology, AGMC & GBP Hospital, P.O. Kunjavan, Agartala, West Tripura, 799006, India.
Indian J Med Microbiol. 2025 Jul-Aug;56:100914. doi: 10.1016/j.ijmmb.2025.100914. Epub 2025 Jul 7.
Enterococcus spp. Has emerged as a significant cause of bacteremia, often leading to severe complications such as Infective Endocarditis. The rise of Vancomycin-Resistant Enterococci (VRE) poses a critical challenge in treating Enterococcal bacteremia, particularly in hospital settings. This study aims to conduct molecular characterization and genotyping of VRE strains isolated from blood samples in a tertiary care hospital.
This hospital-based prospective cross-sectional study was conducted at a tertiary care hospital in Tripura, Northeast India, from August 2021 to December 2024. Blood samples from both adult and pediatric patients were collected and processed for culture and organism identification following departmental protocols. Antimicrobial susceptibility of isolated Enterococcus spp. Was assessed, and vancomycin resistance confirmed through VRE screening. Real-time PCR was employed for VRE gene detection, and ERIC-PCR was used for genotyping the VRE strains.
During the study, 626 blood samples were analyzed, with 263 (42 %) testing positive for pathogens. Enterococcus spp. Was the third most common isolate (21.7 %), predominantly E. faecalis (63.2 %). Most cases originated from ICU (52.6 %) and the Medicine Department (49.1 %). Linezolid showed 100 % sensitivity, while Vancomycin had 75.4 % sensitivity. Ciprofloxacin exhibited the highest resistance (44 % sensitivity). VRE was detected in 14 strains (24.6 %), all carrying the VanA gene. ERIC-PCR identified three clusters, with most isolates (n=11) in Cluster III, including the ATCC control strain.
This study highlighted the prevalence, resistance patterns, and molecular characteristics of Enterococcus spp. Causing bloodstream infections in a Northeast Indian state. The predominance of VanA-mediated resistance and its clustering in critical care settings call for immediate attention to infection control and targeted antimicrobial strategies. Future research should focus on the environmental and epidemiological factors contributing to the spread of VRE in hospital as well as community settings in the region.
肠球菌已成为菌血症的重要病因，常导致严重并发症，如感染性心内膜炎。耐万古霉素肠球菌（VRE）的出现对治疗肠球菌菌血症构成了严峻挑战，尤其是在医院环境中。本研究旨在对一家三级护理医院从血样中分离出的VRE菌株进行分子特征分析和基因分型。
这项基于医院的前瞻性横断面研究于2021年8月至2024年12月在印度东北部特里普拉的一家三级护理医院进行。按照科室规程采集成人和儿科患者的血样，并进行培养和病原体鉴定处理。评估分离出的肠球菌属的抗菌药敏性，并通过VRE筛查确认万古霉素耐药性。采用实时PCR检测VRE基因，用ERIC-PCR对VRE菌株进行基因分型。
研究期间，共分析了626份血样，其中263份（42%）病原体检测呈阳性。肠球菌属是第三常见的分离菌（21.7%），主要是粪肠球菌（63.2%）。大多数病例来自重症监护病房（52.6%）和内科（49.1%）。利奈唑胺显示出100%的敏感性，而万古霉素的敏感性为75.4%。环丙沙星的耐药性最高（敏感性为44%）。在分离出的14株菌株（24.6%）中检测到VRE，所有菌株均携带VanA基因。ERIC-PCR鉴定出三个簇，大多数分离株（n=11）在簇III中，包括ATCC对照菌株。
本研究突出了印度东北部一个邦引起血流感染的肠球菌属的流行情况、耐药模式和分子特征。VanA介导的耐药性占主导地位及其在重症监护环境中的聚集情况，需要立即关注感染控制和有针对性的抗菌策略。未来的研究应关注导致该地区医院及社区环境中VRE传播的环境和流行病学因素。
