Determination of putative virulence factors among clinical isolates of enterococci isolated from a military hospital in the eastern province of Saudi Arabia

Authors

  • Siju Kankalil George Department of Clinical Laboratory Sciences, Prince Sultan Military College of Health Sciences, Dhahran, Eastern province, Kingdom of Saudi Arabia
  • M. R. Suseela Department of Microbiology, Rajah Muthiah Medical College, Annamalai University, Tamil Nadu, India
  • Saleh El Safi Department of Clinical Laboratory Sciences, Prince Sultan Military College of Health Sciences, Dhahran, Eastern province, Kingdom of Saudi Arabia
  • El Moiez Ali El Nagi Department of Clinical Laboratory Sciences, Prince Sultan Military College of Health Sciences, Dhahran, Eastern province, Kingdom of Saudi Arabia
  • Ahmed Adlan Mohammed Adam Department of Clinical Laboratory Sciences, Prince Sultan Military College of Health Sciences, Dhahran, Eastern province, Kingdom of Saudi Arabia
  • Ashly Mary Jacob Department of Clinical Laboratory Sciences, Prince Sultan Military College of Health Sciences, Dhahran, Eastern province, Kingdom of Saudi Arabia
  • Thekra Al-Maqati Department of Clinical Laboratory Sciences, Prince Sultan Military College of Health Sciences, Dhahran, Eastern province, Kingdom of Saudi Arabia
  • Abdullah Al Shehri Department of Clinical Laboratory Sciences, Prince Sultan Military College of Health Sciences, Dhahran, Eastern province, Kingdom of Saudi Arabia
  • Harish Kumar K. S. Department of Medical Microbiology, School of Medical Education, Mahatma Gandhi University, Kerala, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20204871

Keywords:

Biofilm, Caseinase, Enterococci, Gelatinase, Haemolysin, Vancomycin resistance

Abstract

Background: The pathogenic potential of enterococci to produce life-threatening infections is well-documented. The scientific community has, of late, evinced a renewed interest in the putative virulence factors of enterococci. Objective of the study was to determine the putative virulence factors of clinically isolated Enterococcus species from a military hospital and to describe the association between virulence factors and vancomycin susceptibility.

Methods: A total of 245 enterococci were isolated from clinical samples collected from KFMMC, a leading military hospital in the eastern province of Saudi Arabia. Following species identification and antimicrobial susceptibility testing using the Vitek 2 system; the isolates were tested for the production of caseinase, gelatinase, biofilm, and presence of haemolysin.

Results: Among the enterococcal isolates, 36.7% produced caseinase, 38% produced gelatinase, 24.1% exhibited biofilm formation, and 30.6% were positive for haemolytic activity. A significant association between vancomycin susceptibility patterns and the virulence factors, gelatinase and haemolytic activity, were noted. No significant associations were observed between vancomycin susceptibility patterns and the presence of caseinase or the formation of biofilms.

Conclusions: Virulence factors are invariably produced by several clinical isolates of enterococci in our hospital, and some virulence factors are associated with vancomycin susceptibility.

References

Lebreton F, Cattoir V. Resistance to glycopeptide antibiotics. bacterial resistance to antibiotics. From Molecules to Man. 2019:51-80.

Parte AC. LPSN–List of prokaryotic names with standing in nomenclature. Int J Syst Evolution Microbiol. 2018;68(6):1825-9. Accessed on 15 August 2020.

Garsin DA, Frank KL, Silanpää J. Pathogenesis and models of enterococcal infection. Available at https://www.ncbi.nlm.nih.gov/books/NBK190426/. Accessed on 12 July 2020.

Chajęcka W, Zadernowska A, Trokenheim Ł. Virulence factors of enterococcus spp. presented in food. LWT. 2017;75:670-6.

Thomas VC, Thurlow LR, Boyle D, Hancock LE. Regulation of autolysis-dependent extracellular DNA release by Enterococcus faecalis extracellular proteases influences biofilm development. J Bacteriol. 2008;190(16):5690-8.

Jett BD, Huycke MM, Gilmore MS. Virulence of enterococci. Clin Microbiol Rev. 1994;7(4):462-78.

Cetinkaya Y, Falk P, Mayhall CG. Vancomycin-resistant enterococci. Clin Microbiol Rev. 2000;13(4):686-707.

Biswas PP, Dey S, Adhikari L, Sen A. Virulence markers of vancomycin-resistant enterococci isolated from infected and colonised patients. J Global Infect Dis. 2014;6(4):157.

Leroy F, Moreno MF, Vuyst L. Enterococcus faecium RZS C5, an interesting bacteriocin producer to be used as a co-culture in food fermentation. Int J Food Microbiol. 2003;88(2-3):235-40.

Huycke MM, Gilmore MS. Frequency of aggregation substance and cytolysin genes among enterococcal endocarditis isolates. Plasmid. 1995;34(2):152-6.

Burns EH, Marciel AM, Musser JM. Activation of a 66-kilodalton human endothelial cell-matrix metalloprotease by Streptococcus pyogenes extracellular cysteine protease. Infect Immunity. 1996;64(11):4744-50.

Sharifi Y, Hasani A, Ghotaslou R. Survey of virulence determinants among vancomycin-resistant Enterococcus faecalis and Enterococcus faecium isolated from clinical specimens of hospitalised patients of Northwest of Iran. The Open Microbiol J. 2012;6:34.

Ahdal M, Abozaid S, Al-Shammary H. Characterisation of Enterococcus faecium isolates and first report of vanB phenotype–vanA genotype incongruence in the Middle East. European J Clin Microbiol Infect Dis. 2012;31(11):3223-9.

Tille P. Bailey & Scott's diagnostic microbiology-e-book. Elsevier Health Sciences; 2015.

Furumura MT, Figueiredo P, Carbonell GV, Darini ALdC, Yano T. Virulence-associated characteristics of Enterococcus faecalis strains isolated from clinical sources. Brazilian J Microbiol. 2006;37(3):230-6.

Vergis EN, Shankar N, Chow JW. Association between the presence of enterococcal virulence factors gelatinase, hemolysin, and enterococcal surface protein and mortality among patients with bacteremia due to Enterococcus faecalis. Clinical Infectious Diseases. 2002;35(5):570-575.

Ike Y, Hashimoto H, Clewell D. High incidence of hemolysin production by Enterococcus (Streptococcus) faecalis strains associated with human parenteral infections. J Clin Microbiol. 1987;25(8):1524-8.

Praharaj I, Sujatha S, Parija SC. Phenotypic and genotypic characterisation of vancomycin-resistant Enterococcus isolates from clinical specimens. Indian J Med Res. 2013;138(4):549.

O'Toole GA. Microtiter dish biofilm formation assay. JoVE. J Visualized Experiments. 2011;47:e2437.

Stepanović S, Vuković D, Hola V. Quantification of biofilm in microtiter plates: overview of testing conditions and practical recommendations for assessment of biofilm production by staphylococci. Apmis. 2007;115(8):891-9.

Mundy L, Sahm D, Gilmore M. Relationships between enterococcal virulence and antimicrobial resistance. Clinic Microbiol Rev. 2000;13(4):513-22.

Baldassarri L, Creti R, Recchia S. Virulence factors in enterococcal infections of orthopedic devices. Int J Artificial Organs. 2006;29(4):402-6.

Duggan JM, Sedgley CM. Biofilm formation of oral and endodontic Enterococcus faecalis. J Endodontics. 2007;33(7):815-8.

Sharifi Y, Hasani A, Ghotaslou R. Virulence and antimicrobial resistance in enterococci isolated from urinary tract infections. Advanced Pharmac Bulletin. 2013;3(1):197.

Tyne VD, Martin MJ, Gilmore MS. Structure, function, and biology of the Enterococcus faecalis cytolysin. Toxins. 2013;5(5):895-911.

Franz CM, Huch M, Abriouel H, Holzapfel W, Gálvez A. Enterococci as probiotics and their implications in food safety. Int J Food Microbiol. 2011;151(2):125-40.

Upadhyaya PG, Umapathy B, Ravikumar K. Comparative study for the presence of enterococcal virulence factors gelatinase, hemolysin and biofilm among clinical and commensal isolates of Enterococcus faecalis. J Laboratory Phys. 2010;2(2):100.

Shankar N, Baghdayan AS, Gilmore MS. Modulation of virulence within a pathogenicity island in vancomycin-resistant Enterococcus faecalis. Nature. 2002;417(6890):746-50.

Arias CA, Murray BE. The rise of the Enterococcus: beyond vancomycin resistance. Nature Rev Microbiol. 2012;10(4):266-78.

Tendolkar PM, Baghdayan AS, Gilmore MS, Shankar N. Enterococcal surface protein, Esp, enhances biofilm formation by Enterococcus faecalis. Infect Immunity. 2004;72(10):6032-9.

Ramadhan A, Hegedus E. Biofilm formation and esp gene carriage in enterococci. J Clin Pathol. 2005;58(7):685-6.

Chng JH, Chong KK, Lam LN, Wong JJ, Kline KA. Biofilm-associated infection by enterococci. Nature Rev Microbiol. 2019;17(2):82-94.

Das A, Banerjee T. Prevalence of urinary tract infections and susceptibility pattern of uropathogens in women of reproductive age group from North India. J Advances Med. 2015;4(1,2):5-9.

Khan MA, Wal M, Farrell DJ. Analysis of van A vancomycin-resistant Enterococcus faecium isolates from Saudi Arabian hospitals reveals the presence of clonal cluster 17 and two new Tn 1546 lineage types. J Antimicrobial Chemother. 2008;62(2):279-83.

Sonbol FI, Banna TES, Abdelaziz AA, Madboly LA. Gelatinase production, antimicrobial resistance and pheromone response of conjugative plasmids of Enterococcus faecalis isolated from Egypt. African J Microbiol Res. 2013;7(40):4775-86.

Terkuran M, Erginkaya Z, Emel Ü. The relationship between virulence factors and vancomycin resistance among Enterococci collected from food and human samples in Southern Turkey. Ankara Üniversitesi Veteriner Fakültesi Dergisi. 2014;61(2):133-40.

Kashef M, Alvandi A, Hasanvand B, Azizi M, Abiri R. Virulence factor and biofilm formation in clinical Enterococcal isolates of the west of Iran. Jundishapur J Microbiol. 2017;10(7):33-8.

Downloads

Published

2020-10-28

How to Cite

George, S. K., Suseela, M. R., El Safi, S., El Nagi, E. M. A., Adam, A. A. M., Jacob, A. M., Al-Maqati, T., Al Shehri, A., & K. S., H. K. (2020). Determination of putative virulence factors among clinical isolates of enterococci isolated from a military hospital in the eastern province of Saudi Arabia. International Journal of Research in Medical Sciences, 8(11), 3860–3865. https://doi.org/10.18203/2320-6012.ijrms20204871

Issue

Section

Original Research Articles