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      Molecular detection of vanA and vanB genes among vancomycin-resistant enterococci in ICU-hospitalized patients in Ahvaz in southwest of Iran

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          Abstract

          Objective

          Nosocomial infections due to vancomycin-resistant enterococci (VRE) are known as a source of spreading these bacteria. The aim of this prospective study was molecular detection of vanA and vanB genes among VRE isolated from patients admitted to intensive care units (ICUs) in Ahvaz in southwest of Iran.

          Materials and methods

          Overall, 243 non-duplicate rectal swab specimens were collected from ICU-hospitalized patients in teaching hospitals affiliated to Ahvaz Jundishapur University of Medical Sciences, Iran. The specimens were inoculated on suitable culture media, and isolates were identified by standard biochemical tests. The susceptibility and resistance of enterococci to 10 antibiotics were determined based on the Clinical and Laboratory Standards Institute guidelines. Resistance to vancomycin was phenotypically detected by vancomycin screening test, and the vanA and vanB genes in vancomycin-resistant isolates were amplified by multiplex PCR method.

          Results

          Of 175 specimens containing enterococci, 129 (73.7%) isolates were detected as Enterococcus faecium and Enterococcus faecalis and 46 (26.3%) isolates as Enterococcus spp. The results of susceptibility test showed high rates of resistance to tetracycline, erythromycin, ciprofloxacin, and ampicillin. Moreover, based on this test, out of 129 Enterococcus isolates, 56 (43.4%) were resistant to vancomycin and teicoplanin. Also, among 59 vancomycin-resistant or semi-susceptible isolates, vanA gene was detected in 54 (91.5%) isolates, while none of the isolates had vanB gene.

          Conclusion

          According to the results of this study, to prevent the spread of vancomycin-resistant Enterococcus strains, especially in nosocomial infections, the susceptibility of isolates should be determined before vancomycin prescription.

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          Most cited references27

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          Enterococcal infections & antimicrobial resistance.

          Enterococci have traditionally regarded as low grade pathogens, have emerged as an increasingly important cause of nosocomial infections in the last decade. Although about a dozen enterococcus species have been identified, only two are responsible for the majority of human infections, i.e., Enterococcus faecalis and E. faecium. The most common nosocomial infections produced by these organisms are urinary tract infections (associated with instrumentation and antimicrobial resistance), followed by intra-abdominal and pelvic infections. They also cause surgical wound infections, bacteraemia, endocarditis, neonatal sepsis and rarely meningitis. A major reason why these organisms survive in hospital environment is the intrinsic resistance to several commonly used antibiotics and, perhaps more importantly, their ability to acquire resistance to all currently available antibiotics, either by mutation or by receipt of foreign genetic material through the transfer of plasmids and transposons. The emergence of vancomycin-resistant enterococci (VRE) is a cause of concern, as once established, it is very difficult to control. Moreover, there can be transfer of resistant gene from enterococci to Staphylococcus aureus thereby posing a threat to the patient safety and also challenges for the treating physicians. This review highlights the shifting spectrum of enterococcal infections, along with their geographical distribution and growing nosocomial importance. Emergence of antimicrobial resistance, pathogenicity and virulence factors, current preventive, control and treatment modalities of severe enterococcal infections are also dealt with.
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            Risk factors for enterococcal infection and colonization by vancomycin-resistant enterococci in critically ill patients.

            Vancomycin-Resistant Enterococci (VRE) are important causes of Intensive Care Unit (ICU) infections. Our goal was to identify the prevalence and risk factors for VRE colonization upon ICU admission and during ICU stay, as well as, their impact in enterococcal infection including vancomycin-susceptible cases (VSE).
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              • Record: found
              • Abstract: not found
              • Article: not found

              Effects of antibiotics on nosocomial epidemiology of vancomycin-resistant enterococci.

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                Author and article information

                Journal
                Infect Drug Resist
                Infect Drug Resist
                Infection and Drug Resistance
                Infection and Drug Resistance
                Dove Medical Press
                1178-6973
                2018
                15 November 2018
                : 11
                : 2269-2275
                Affiliations
                [1 ]Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran, moosavian_m@ 123456yahoo.com
                [2 ]Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran, moosavian_m@ 123456yahoo.com
                [3 ]School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
                Author notes
                Correspondence: Mojtaba Moosavian, Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, 61357-15794 Ahvaz, Iran, Tel +98 91 6313 2848, Email moosavian_m@ 123456yahoo.com
                Article
                idr-11-2269
                10.2147/IDR.S177886
                6245376
                30532561
                87796810-e9a4-4f65-a8e2-52ac653b2b3a
                © 2018 Moosavian et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                History
                Categories
                Original Research

                Infectious disease & Microbiology
                enterococcus faecalis,enterococcus faecium,multiplex pcr,vancomycin

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