Detection of various virulence factors in high level aminoglycoside resistance and vancomycin resistant enterococci isolates of uropathogenic Enterococci
DOI:
https://doi.org/10.18203/2320-6012.ijrms20191668Keywords:
Enterococcus, HLAR, Uropathogenic, Virulence factors, VREAbstract
Background: Enterococci are common commensal organism of enteric tract and act as opportunistic pathogen and may cause infection in community as well as in hospitalised individuals. In present study association of several types of virulence factors like haemolysin, gelatinase and biofilm formation have been studied among HLAR and Vancomycin resistant Enterococci (VRE) isolates of enterococci among UTI patients.
Methods: The samples were collected from all hospitalized and OPD patients of MBS Hospital, JK Lone Hospital and NMC Hospital. Government Medical College, Kota, Rajasthan, India. A total of 360 isolates of enterococcus were collected during the period of 2 years from April 2016 to April 2018 in microbiology laboratory, Department of Microbiology, Government Medical College, Kota, Rajasthan, India. All virulence factors were detected by phenotypic methods and MIC values were detected for high level gentamicin and vancomycin.
Results: Among all enterococcal isolates most common factor was biofilm production 191 (53.05%) followed by haemolysin 131 (36.38%) and gelatinase production 72 (20%). Total resistant (MIC> 500 µg/ml) isolates for gentamicin was 194 (89.4%). In agar dilution 14 (11.2%) isolates were found sensitive, 61 (48.8%) isolates were found intermediate and 50 (40%) isolates were found to be resistant for vancomycin. HLAR and VRE was maximum associated with haemolysin + bio-film followed by gelatinase+biofilm, haemolysin+gelatinase+bio- film and least with haemolysin + gelatinase.
Conclusions: In present study enterococcus show significant production of biofilm and other virulence factors. With production of biofilm they become more resistant to routinely used concentration of antibiotics posing threat for treatment failure. A continuous monitoring is needed particularly for resistance to aminoglycoside and vancomycin to stop their institutional spread. Judicial use of antibiotics should be encouraged both in community as well as in institutions.
Metrics
References
Teixeria LM, Faclam RR. In: Enterococcus, Topley and Wilson's Microbiology and Microbial Infections, S. Peter Borriello, Patrick R. Murray, Guido Funke, ed. 10th Bacteriology, Wiley; 2006;2:2-10.
Fisher K, Phillips C. The ecology, epidemiology and virulence of Enterococcus. Microbiol. 2009;155(6):1749-57.
Comerlato CB, Resende MC, Caierão J, d'Azevedo PA. Presence of virulence factors in Enterococcus faecalis and Enterococcus faecium susceptible and resistant to vancomycin. Mem Inst Oswaldo Cruz. 2013;108;(5): 590-5.
Ike YA, Hashimoto HA, Clewell DB. High incidence of hemolysin production by enterococcus (Streptococcus) faecalis strains associated with human parenteral infections. J Clinic Microbio. 1987;25(8):1524-8.
Upadhyaya PG, Ravikumar KL, Umapathy BL. Review of virulence factors of enterococcus: an emerging nosocomial pathogen. Indian J Med Microbiol. 2009;27(4):301.
Praharaj Ira, Sistla Sujatha, Parija Subhash Chandra. Virulence factors in clinical and commensal isolates of Enterococcus species. Indian J Pathol Microbiol. 2013;56:24-30.
Mittal S, Singla P, Deep A, Bala K, Sikka R, Garg M, Chaudhary U. Vancomycin and high-level aminoglycoside resistance in enterococcus spp. in a tertiary health care centre: A therapeutic Concern. J Pathog. 2016;1-5.
Himedia Lab. Gentamicin Ezy MICTM Strip (HLG) (0.064-1024 mcg/ml). Available at: www.himedialabs.com/TD/EM061.pdf.
Winn W, Allen S, Janda W, Koneman E, Procop G, Schreckenberger P. Antimicrobial susceptibility testing. Koneman’s colour at las and textbook of diagnostic microbiology. 6th ed. Lippincott Williams and Wilkins; 2006; 996.
Swenson MJ, Ferraro JM, Sahm DF, Doern G, P faller MA, Reller BL, et al. Development of a standardized screening method for detection of vancomycin-resistant enterococci. J Clinic Microbio. 1994;32(7):1700-4.
Miller WR, Munita JM, Arias CA. Mechanisms of antibiotic resistance in enterococci. Expert Rev Anti Infect Ther. 2014;12(10):1221-36.
Costa Y, Galimand M, Leclercq R, Duval J, Courvalin P. Characterization of the chromosomal aac (6′)-Ii gene specific for enterococcus faecium. Antimicrob Agents Chemother. 1993; 37:1896-903.
Eliopoulos GM, Farber BF, Murray BE, Wennersten C, Moellering RC. Ribosomal resistance of clinical enterococcal to streptomycin isolates. Antim Agents Chemoth. 1984;25(3):398-9.
Courvalin PA, Carlier CE, Collatz EK. Plasmid-mediated resistance to aminocyclitol antibiotics in group D streptococci. J Bacterio. 1980;143(2):541-51.