Emergence of multidrug resistance and extensive drug resistance among enterococcal clinical isolates in Egypt
Heba Shehta Said, Eman Salama Abdelmegeed Department of Microbiology and Immunology, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt Introduction: Enterococci commonly inhabit the gastrointestinal tract of both human and animals; however, they have emerged as a leading cause of sever...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2019-05-01
|
| Series: | Infection and Drug Resistance |
| Subjects: | |
| Online Access: | https://www.dovepress.com/emergence-of-multidrug-resistance-and-extensive-drug-resistance-among--peer-reviewed-article-IDR |
| _version_ | 1819033911241474048 |
|---|---|
| author | Said HS Abdelmegeed ES |
| author_facet | Said HS Abdelmegeed ES |
| author_sort | Said HS |
| collection | DOAJ |
| description | Heba Shehta Said, Eman Salama Abdelmegeed Department of Microbiology and Immunology, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt Introduction: Enterococci commonly inhabit the gastrointestinal tract of both human and animals; however, they have emerged as a leading cause of several infections with substantial morbidity and mortality. Their ability to acquire resistance combined with intrinsic resistance to various antimicrobials makes treatment of enterococcal infections challenging. Materials and methods: The aim of the study was to evaluate the antimicrobial resistance pattern, and assess the prevalence of multidrug resistance (MDR) and extensive drug resistance (XDR) among enterococcal isolates, collected from different clinical sources, in Mansoura University Hospitals, Egypt.Results: Antibiotic sensitivity testing revealed elevated levels of resistance among enterococcal clinical isolates (N=103). All E. faecium (N=32) and 74.6% of E. faecalis isolates (N=71) were MDR, while two E. faecalis and four E. faecium isolates were XDR. High level gentamicin resistance was detected in 79.6%, most of them carried the aac(6’)-Ie-aph(2’’)-Ia gene. High level streptomycin resistance was seen in 36.9%, of which 52.6% carried the ant(6’)-Ia gene. Resistance to macrolides and lincosamides were mediated by ermB (92.2%) and msrA/B (42.7%). tetK, tetL, and tetM genes were detected among tetracyclines resistant isolates. Resistance to vancomycin was detected in 15.5%, where vanB and vanC1 gene clusters were detected in VRE isolates. Ten isolates (9.7%) were resistant to linezolid, eight of which harbored the optrA gene. Vancomycin and linezolid resistant enterococci were more likely to exhibit strong/moderate biofilm formation than vancomycin and linezolid sensitive ones.Conclusion: Elevated levels of resistance to different classes of antimicrobial agents and emergence of MDR and XDR strains pose a major threat with limited therapeutic options for infections caused by this emerging pathogen. Keywords: enterococci, antibiotic resistance, biofilm formation, RAPD typing, MDR enterococci, XDR enterococci, VRE, linezolid resistant enterococci |
| first_indexed | 2024-12-21T07:25:21Z |
| format | Article |
| id | doaj.art-ed9c634f38b4467190cbcb0a68d0fc6b |
| institution | Directory Open Access Journal |
| issn | 1178-6973 |
| language | English |
| last_indexed | 2024-12-21T07:25:21Z |
| publishDate | 2019-05-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Infection and Drug Resistance |
| spelling | doaj.art-ed9c634f38b4467190cbcb0a68d0fc6b2022-12-21T19:11:41ZengDove Medical PressInfection and Drug Resistance1178-69732019-05-01Volume 121113112545645Emergence of multidrug resistance and extensive drug resistance among enterococcal clinical isolates in EgyptSaid HSAbdelmegeed ESHeba Shehta Said, Eman Salama Abdelmegeed Department of Microbiology and Immunology, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt Introduction: Enterococci commonly inhabit the gastrointestinal tract of both human and animals; however, they have emerged as a leading cause of several infections with substantial morbidity and mortality. Their ability to acquire resistance combined with intrinsic resistance to various antimicrobials makes treatment of enterococcal infections challenging. Materials and methods: The aim of the study was to evaluate the antimicrobial resistance pattern, and assess the prevalence of multidrug resistance (MDR) and extensive drug resistance (XDR) among enterococcal isolates, collected from different clinical sources, in Mansoura University Hospitals, Egypt.Results: Antibiotic sensitivity testing revealed elevated levels of resistance among enterococcal clinical isolates (N=103). All E. faecium (N=32) and 74.6% of E. faecalis isolates (N=71) were MDR, while two E. faecalis and four E. faecium isolates were XDR. High level gentamicin resistance was detected in 79.6%, most of them carried the aac(6’)-Ie-aph(2’’)-Ia gene. High level streptomycin resistance was seen in 36.9%, of which 52.6% carried the ant(6’)-Ia gene. Resistance to macrolides and lincosamides were mediated by ermB (92.2%) and msrA/B (42.7%). tetK, tetL, and tetM genes were detected among tetracyclines resistant isolates. Resistance to vancomycin was detected in 15.5%, where vanB and vanC1 gene clusters were detected in VRE isolates. Ten isolates (9.7%) were resistant to linezolid, eight of which harbored the optrA gene. Vancomycin and linezolid resistant enterococci were more likely to exhibit strong/moderate biofilm formation than vancomycin and linezolid sensitive ones.Conclusion: Elevated levels of resistance to different classes of antimicrobial agents and emergence of MDR and XDR strains pose a major threat with limited therapeutic options for infections caused by this emerging pathogen. Keywords: enterococci, antibiotic resistance, biofilm formation, RAPD typing, MDR enterococci, XDR enterococci, VRE, linezolid resistant enterococcihttps://www.dovepress.com/emergence-of-multidrug-resistance-and-extensive-drug-resistance-among--peer-reviewed-article-IDREnterococciantibiotic resistancebiofilm formationRAPD typingMDR enterococciXDR enterococciVRELinezolid resistant enterococci |
| spellingShingle | Said HS Abdelmegeed ES Emergence of multidrug resistance and extensive drug resistance among enterococcal clinical isolates in Egypt Infection and Drug Resistance Enterococci antibiotic resistance biofilm formation RAPD typing MDR enterococci XDR enterococci VRE Linezolid resistant enterococci |
| title | Emergence of multidrug resistance and extensive drug resistance among enterococcal clinical isolates in Egypt |
| title_full | Emergence of multidrug resistance and extensive drug resistance among enterococcal clinical isolates in Egypt |
| title_fullStr | Emergence of multidrug resistance and extensive drug resistance among enterococcal clinical isolates in Egypt |
| title_full_unstemmed | Emergence of multidrug resistance and extensive drug resistance among enterococcal clinical isolates in Egypt |
| title_short | Emergence of multidrug resistance and extensive drug resistance among enterococcal clinical isolates in Egypt |
| title_sort | emergence of multidrug resistance and extensive drug resistance among enterococcal clinical isolates in egypt |
| topic | Enterococci antibiotic resistance biofilm formation RAPD typing MDR enterococci XDR enterococci VRE Linezolid resistant enterococci |
| url | https://www.dovepress.com/emergence-of-multidrug-resistance-and-extensive-drug-resistance-among--peer-reviewed-article-IDR |
| work_keys_str_mv | AT saidhs emergenceofmultidrugresistanceandextensivedrugresistanceamongenterococcalclinicalisolatesinegypt AT abdelmegeedes emergenceofmultidrugresistanceandextensivedrugresistanceamongenterococcalclinicalisolatesinegypt |