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Getahun Strobel A, Prasad P, Prasad V, Naidu R, Young-Sharma T, Suka A, Richards M, Cameron D, Lane CR, Buising K, Howden BP, Autar S. The epidemiology of enterococci in a tertiary hospital and primary healthcare facilities in Fiji (2019-2022). J Glob Antimicrob Resist 2024; 37:102-107. [PMID: 38565419 DOI: 10.1016/j.jgar.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/28/2024] [Accepted: 03/05/2024] [Indexed: 04/04/2024] Open
Abstract
OBJECTIVES We analysed 4 y of laboratory data to characterise the species and determine the antimicrobial susceptibility profiles of enterococci as human pathogens in Fiji. The study also investigated the molecular epidemiology amongst the subset of vancomycin-resistant enterococci (VRE). METHODS This retrospective study reviewed bacteriological data from Colonial War Memorial Hospital (CWMH) and other healthcare facilities in the Central and Eastern divisions of Fiji. Phenotypic, antimicrobial susceptibility and vanA and vanB PCR testing were performed using locally approved protocols. The first clinical isolates per patient with antimicrobial susceptibility testing results in a single year were included in the analysis. Data was analysed using WHONET software and Microsoft Excel. RESULTS A total of 1817 enterococcal isolates were reported, 1415 from CWMH and 402 from other healthcare facilities. The majority of isolates, 75% (n = 1362) were reported as undifferentiated Enterococcus spp., 17.8% (n = 324) were specifically identified as Enterococcus faecalis and 6.7% (n = 122) as E. faecium. Overall, 10% of the enterococci isolates were from blood cultures. Among isolates from CWMH, <15% of E. faecium were susceptible to ampicillin, and 17.2% were vancomycin resistant. Overall, 874 enterococcal isolates (including the undifferentiated species) were tested against vancomycin, of which 4.8% (n = 42) were resistance. All of the VRE isolates tested (n = 15) expressed vanA genes. CONCLUSIONS This study demonstrates the clinical importance of VRE, particularly van A E. faecium in the national referral hospital in Fiji. Enhanced phenotypic and molecular surveillance data are needed to better understand enterococci epidemiology and help guide specific infection prevention and control measures and antibiotic prescribing guidelines.
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Affiliation(s)
- Aneley Getahun Strobel
- Department of Infectious Diseases, The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia.
| | - Prinika Prasad
- Ministry of Health and Medical Services, Colonial War Memorial Hospital, Suva, Fiji
| | - Vinita Prasad
- Ministry of Health and Medical Services, Colonial War Memorial Hospital, Suva, Fiji
| | - Ravi Naidu
- Ministry of Health and Medical Services, Colonial War Memorial Hospital, Suva, Fiji
| | - Tracey Young-Sharma
- Ministry of Health and Medical Services, Colonial War Memorial Hospital, Suva, Fiji
| | - Ana Suka
- Ministry of Health and Medical Services, Colonial War Memorial Hospital, Suva, Fiji
| | - Matthew Richards
- Infection Prevention and Surveillance Service, The Royal Melbourne Hospital, Melbourne, Australia
| | - Donna Cameron
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at Peter Doherty Institute for infection and Immunity, Melbourne, Australia
| | - Courtney R Lane
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at Peter Doherty Institute for infection and Immunity, Melbourne, Australia
| | - Kirsty Buising
- Department of Infectious Diseases, The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia; The Royal Melbourne Hospital, Melbourne, Australia
| | - Benjamin P Howden
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at Peter Doherty Institute for infection and Immunity, Melbourne, Australia.
| | - Sanjeshni Autar
- Ministry of Health and Medical Services, Colonial War Memorial Hospital, Suva, Fiji
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Lohikoski R, Oldberg K, Rasmussen M. Bacteraemia caused by non-faecalis and non-faecium Enterococcus species-a retrospective study of incidence, focus of infection, and prognosis. Eur J Clin Microbiol Infect Dis 2024; 43:45-53. [PMID: 37919410 PMCID: PMC10774187 DOI: 10.1007/s10096-023-04690-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/21/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND/AIM Enterococcus faecalis and Enterococcus faecium cause human infections including bacteraemia and infective endocarditis (IE). Only few studies describing non-faecalis and non-faecium Enterococcus (NFE) infections have been conducted. We aimed to describe the incidence, prognosis, and focus of infection of bacteraemia with NFE. METHODS This retrospective population-based study included all episodes of patients having a blood culture with growth of NFE between 2012 and 2019 in Region Skåne, Sweden. Information was collected from medical records. Episodes of bacteraemia caused by NFE were compared to episodes of bacteraemia caused by E. faecalis and E. faecium. RESULTS During the study period, 136 episodes with NFE bacteraemia were identified corresponding to an incidence of NFE bacteraemia of 16 cases per 1,000,000 person-years among adults. Enterococcus casseliflavus (n=45), Enterococcus gallinarum (n=34), and Enterococcus avium (n=29) were the most common species. The most common foci of infection were biliary tract infections (n=17) followed by gastrointestinal infections (n=7). Urinary tract infections were not commonly caused by NFE (n=1), and no episodes of IE were caused by NFE. Polymicrobial bacteraemia was more common with NFE (73%) than with E. faecalis (35%) and E. faecium (42%). Community acquired infections were more common in bacteraemia with NFE compared to E. faecium. 30- and 90-day survival rates were 76% and 68%, respectively, and recurrent NFE bacteraemia was seen after 3% of the episodes. CONCLUSION Bacteraemia caused by NFE is rare and is often polymicrobial. Biliary tract focus is common in NFE bacteraemia whereas IE and urinary tract focus are uncommon.
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Affiliation(s)
- Roni Lohikoski
- Division of Infection Medicine, Department of Clinical Sciences Lund, Lund University, BMC B14, SE-223 63, Lund, Sweden
- Skåne University Hospital, Malmö, Sweden
| | - Karl Oldberg
- Division of Infection Medicine, Department of Clinical Sciences Lund, Lund University, BMC B14, SE-223 63, Lund, Sweden
- Department of Clinical Microbiology, Region Skåne, Lund, Sweden
| | - Magnus Rasmussen
- Division of Infection Medicine, Department of Clinical Sciences Lund, Lund University, BMC B14, SE-223 63, Lund, Sweden.
- Skåne University Hospital, Lund, Sweden.
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Mathur A, Parihar AS, Modi S, Kalra A. Photodynamic therapy for ESKAPE pathogens: An emerging approach to combat antimicrobial resistance (AMR). Microb Pathog 2023; 183:106307. [PMID: 37604213 DOI: 10.1016/j.micpath.2023.106307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/09/2023] [Accepted: 08/14/2023] [Indexed: 08/23/2023]
Abstract
The increase in antimicrobial resistance, particularly in ESKAPE pathogens, has resulted in the dire need for new therapeutic approaches. ESKAPE is an acronym for a group of bacteria that are responsible for a majority of nosocomial and community acquired infections. The acronym stands for Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species. These pathogens are known for their ability to develop resistance to multiple antibiotics, making them difficult to treat thus posing a significant threat to public health. In light of the alarming consequences of antimicrobial resistance, it has been estimated that, in the absence of a substantial increase in the rate of development of new effective drugs, the number of casualties related to these infections will increase from about 700,000 in 2016 up to nearly 10,000,000 in 2050 [1]. One potential strategy to treat these pathogens is photodynamic therapy (PDT). In the early 20th century, Oscar Raab observed the phototoxicity of acridine red against Paramecium caudatum, while Tappenier and Jesionek demonstrated the photodynamic effects of eosin for treating cutaneous diseases. These discoveries laid the foundation for Photodynamic Therapy (PDT), which utilizes a non-toxic photosensitizer (PS) followed by targeted light irradiation for treatment [2]. PDT involves the use of a photosensitizer, a light source, and oxygen to eliminate highly active infectious pathogens such as bacteria, viruses, and fungi. PDT is known to possess several advantages including localized treatment and fewer side effects. Various photosensitizers and light sources have been assessed in different strains, showing promising results suggesting PDT to be a promising potential treatment option. PDT utilizes PS compounds with suitable light absorption that showcase effective results against the pathogens in vitro and in vivo, including BODIPY derivatives, Methylene Blue, and other dyes like porphyrin derivatives, phthalocyanines, indole derivatives, Photophrin, etc., inhibiting the growth of infections, for both in planktonic cells and in biofilms. Combination of PDT with other therapies like efflux pump inhibitors or quorum sensing inhibitors has also proven to be efficacious. However, this domain further needs to be assessed before it reaches the society.
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Affiliation(s)
| | | | - Simran Modi
- Dr. B. Lal Institute of Biotechnology, Jaipur, India
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4
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Sivakumar R, Park SY, Lee NY. Quercetin-Mediated Silver Nanoparticle Formation for the Colorimetric Detection of Infectious Pathogens Coupled with Loop-Mediated Isothermal Amplification. ACS Sens 2023; 8:1422-1430. [PMID: 36952605 DOI: 10.1021/acssensors.2c02054] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
Here, quercetin-mediated silver nanoparticle (AgNP) formation combined with loop-mediated isothermal amplification (LAMP) was introduced to colorimetrically detect two major infectious pathogens, SARS-CoV-2 and Enterococcus faecium, using a foldable PMMA microdevice. The nitrogenous bases of LAMP amplicons can readily form a complex with Ag+ ions, and the catechol moiety in quercetin, which acted as a reducing agent, could be chelated with Ag+ ions, resulting in the easy electron transfer from the oxidant to the reductant and producing brown-colored AgNPs within 5 min. The introduced method exhibited higher sensitivity than agarose gel electrophoresis due to more active redox centers in quercetin. The detection limit was attained at 101 copies μL-1 and 101 CFU mL-1 for SARS-CoV-2 RNA and E. faecium, respectively. A foldable microdevice made of two pieces of PMMA that fully integrates DNA extraction, amplification, and detection processes was fabricated to establish practical applicability. On one PMMA, DNA extraction was performed in a reaction chamber inserted with an FTA card, and then LAMP reagents were added for amplification. Silver nitrate was added to the reaction chamber after LAMP. On the other PMMA, quercetin-soaked paper discs loaded in the detection chamber were folded toward the reaction chamber for colorimetric detection. An intense brown color was produced within 5 min when heated at 65 °C. The introduced colorimetric assay, which is highly favorable for laboratory and on-site applications, could be a valuable alternative to conventional methods for detecting infectious diseases, given its unique principle, simplicity, and naked-eye detection.
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Affiliation(s)
- Rajamanickam Sivakumar
- Department of BioNano Technology, Gachon University, 1342 Seongnam-daero, Sujeong-gu, Seongnam-si, Gyeonggi-do 13120, South Korea
| | - So Yeon Park
- Department of BioNano Technology, Gachon University, 1342 Seongnam-daero, Sujeong-gu, Seongnam-si, Gyeonggi-do 13120, South Korea
| | - Nae Yoon Lee
- Department of BioNano Technology, Gachon University, 1342 Seongnam-daero, Sujeong-gu, Seongnam-si, Gyeonggi-do 13120, South Korea
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5
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Vancomycin-Resistant Enterococcus faecium and the emergence of new Sequence Types associated with Hospital Infection. Res Microbiol 2023; 174:104046. [PMID: 36858192 DOI: 10.1016/j.resmic.2023.104046] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/16/2023] [Accepted: 02/20/2023] [Indexed: 03/02/2023]
Abstract
Enterococcus faecium is a major cause of vancomycin-resistant enterococcal (VRE) infection. New variants of the pathogen have emerged and become dominant in healthcare settings. Two such examples, vanB ST796 and vanA ST1421 sequence types, originally arose in Australia and proceeded to cause VRE outbreaks in other countries. Of concern is the detection of a vancomycin variable enterococcal (VVE) variant of ST1421 in Europe that exhibits a vancomycin-susceptible phenotype but which can revert to resistant in the presence of vancomycin. The recent application of genome sequencing for increasing our understanding of the evolution and spread of VRE is also explored here.
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Salem MA, Salama MM, Ezzat SM, Hashem YA. Comparative metabolite profiling of four polyphenol rich Morus leaves extracts in relation to their antibiofilm activity against Enterococcus faecalis. Sci Rep 2022; 12:20168. [PMID: 36424446 PMCID: PMC9691725 DOI: 10.1038/s41598-022-24382-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 11/15/2022] [Indexed: 11/27/2022] Open
Abstract
Enterococci are a common cause of urinary tract infections. The severity of enterococcal infections is associated with their ability to form biofilms. Morus leaves are known as a natural antibacterial, however, their antibiofilm activity against Enterococcus remains unveiled. This study aimed to evaluate the ability of four polyphenol-rich Morus leaves extracts (Morus nigra, M. rubra, M. macroura, and M. alba) to inhibit biofilm formed by enterococcal clinical isolates in relation to their metabolic profiling. Results revealed that 48% of the isolates formed strong biofilm, 28% formed moderate biofilm, 20% formed weak biofilm, and only 4% did not form a biofilm. The strong biofilm-forming isolates were E. faecalis, and hence were chosen for this study. The antibiofilm activity of the four polyphenol-rich Morus leaves extracts revealed that the M. nigra extract exhibited the highest percentage of biofilm inhibition followed by M. rubra then M. macroura and the least inhibition was detected in M. alba, and these results were in accordance with the phenolic and flavonoid contents of each extract. UPLC-ESI-MS/MS identified 61 polyphenolic compounds in the four extracts. Further, multivariate analysis confirmed clear segregation of M. nigra from the other species suggesting disparity in its metabolome, with accumulation of flavonoids, anthocyanidins, phenolic acids and coumarin derivatives. Quercetin and kaempferol glycosides were found to be positively and significantly correlated to the antibiofilm activity. In conclusion, M. nigra ethanolic extracts showed the highest phenolic content and antibiofilm activity and they could be developed as a complementary treatment for the development of antimicrobial agents.
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Affiliation(s)
- Mohamed A. Salem
- grid.411775.10000 0004 0621 4712Department of Pharmacognosy and Natural Products, Faculty of Pharmacy, Menoufia University, Gamal Abd El Nasr St., Shibin Elkom, 32511 Menoufia Egypt
| | - Maha M. Salama
- grid.7776.10000 0004 0639 9286Department of Pharmacognosy, Faculty of Pharmacy, Cairo University, Kasr El-Aini St, Cairo, 11562 Egypt ,grid.440862.c0000 0004 0377 5514Department of Pharmacognosy, Faculty of Pharmacy, The British University in Egypt, Suez Desert Road, El Sherouk City, Cairo, 11837 Egypt
| | - Shahira M. Ezzat
- grid.7776.10000 0004 0639 9286Department of Pharmacognosy, Faculty of Pharmacy, Cairo University, Kasr El-Aini St, Cairo, 11562 Egypt ,grid.442760.30000 0004 0377 4079Department of Pharmacognosy, Faculty of Pharmacy, October University for Modern Sciences and Arts (MSA), Giza, 12451 Egypt
| | - Yomna A. Hashem
- grid.440862.c0000 0004 0377 5514Department of Microbiology, Faculty of Pharmacy, The British University in Egypt, Suez Desert Road, El Sherouk City, Cairo, 11837 Egypt
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7
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Hashem YA, Abdelrahman KA, Aziz RK. Phenotype-Genotype Correlations and Distribution of Key Virulence Factors in Enterococcus faecalis Isolated from Patients with Urinary Tract Infections. Infect Drug Resist 2021; 14:1713-1723. [PMID: 34007190 PMCID: PMC8123086 DOI: 10.2147/idr.s305167] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 04/07/2021] [Indexed: 12/14/2022] Open
Abstract
Background and Objective Enterococcus faecalis can cause different nosocomial infections, especially urinary tract infection (UTI). Pathogenicity of E. faecalis is driven by various virulence factors; however, no specific genetic pattern is restricted to a particular type of infection. The current study aimed to investigate the correlation between different virulence factors in E. faecalis clinical isolates causing UTIs. Methods We phenotypically analyzed 60 urinary isolates, identified as E. faecalis, for biofilm formation, gelatinase, protease and hemolytic activities by Crystal Violet assay, gelatin hydrolysis, casein hydrolysis and blood agar hemolysis assays, respectively. Additionally, we detected different genes associated with species identification, virulence phenotypes, adherence and quorum sensing by the polymerase chain reaction (PCR). The detected genes included D-alanine-D-alanine ligase (ddl), cytolysin (cyl), gelatinase (gelE), serine protease (sprE), faecal streptococci regulator locus genes (fsrA, fsrB, fsrC), pili (pil), adhesin to collagen of E. faecalis (ace) and aggregation substance (agg). Results All isolates formed biofilms, mostly with strong to moderate ability. Although gelE was detected in 87% of the isolates, only 22% of the isolates had gelatinase activity. Similar phenotype-genotype incongruities were observed with hemolysis and casein hydrolysis activities, as the isolates that expressed these two phenotypes were fewer than those carrying the genes encoding them. Conclusion A clear variability in virulence gene distribution among the isolates was observed, and no particular pattern was associated with UTI. Whereas all isolates carried at least ace and pil, whose products are involved in adherence, which is a virulence phenotype that is required for urinary colonization, six isolates carried the entire set of investigated genes. Statistical analysis of the results suggests cyl as a biomarker for hemolytic activity, fsrB as a diagnostic biomarker for the gelatinase activity, and gelE-sprE as predictors for biofilm formation strength in E. faecalis.
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Affiliation(s)
- Yomna A Hashem
- Department of Microbiology, Faculty of Pharmacy, The British University in Egypt, Cairo, Egypt
| | - Khaled A Abdelrahman
- Department of Microbiology, Faculty of Pharmacy, The British University in Egypt, Cairo, Egypt
| | - Ramy K Aziz
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo, Egypt.,Microbiology and Immunology Research Program, Children's Cancer Hospital Egypt, 57357, Cairo, Egypt
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Zhang L, Li H, Gao J, Gao J, Wei D, Qi Y. Identification of drug-resistant phenotypes and resistance genes in Enterococcus faecalis isolates from animal feces originating in Xinjiang, People’s Republic of China. CANADIAN JOURNAL OF ANIMAL SCIENCE 2020. [DOI: 10.1139/cjas-2018-0161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study examined the presence and the antibiotic resistance patterns of Enterococcus faecalis isolated from the feces of 285 animals. Polymerase chain reaction tests verified the presence of E. faecalis from 49 pigs, 20 cows, 174 sheep, 17 horses, 21 chickens, and four dung beetles. Bacterial strains from different animals showed differences in susceptibility and resistance to the tested antimicrobials. The isolates exhibited resistance to ampicillin (6.32%), ciprofloxacin (40.00%), nitrofurantoin (1.40%), erythromycin (54.04%), streptomycin (82.11%), tetracycline (45.26%), amoxicillin (64.91%), penicillin (92.28%), and vancomycin (0.35%). The resistant strains also possessed varying complements of resistance genes including tem (77.89%), tetM (33.68%), gyrA (37.54%), parC (34.74%), aph(3′)-III (22.46%), aac(6′)/aph2″ (10.88%), and ant(6′)-I (8.42%). Genes for vancomycin resistance (vanB and vanC) and erythromycin resistance (mefA) were not detected. These results indicate high levels of antibiotic resistance among the isolates, although no positive correlation was observed between resistance genes and antibiotic resistance spectrum.
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Affiliation(s)
- Li Zhang
- Ningxia University, Yinchuan 750021, People’s Republic of China
| | - Hui Li
- Department of Animal Science and Technology, Shihezi University, Shihezi 832000, People’s Republic of China
| | - Jingwen Gao
- Department of Animal Science and Technology, Shihezi University, Shihezi 832000, People’s Republic of China
| | - Jianpeng Gao
- Department of Animal Science and Technology, Shihezi University, Shihezi 832000, People’s Republic of China
| | - Dianhua Wei
- Department of Animal Science and Technology, Shihezi University, Shihezi 832000, People’s Republic of China
| | - Yayin Qi
- Department of Animal Science and Technology, Shihezi University, Shihezi 832000, People’s Republic of China
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Wood MW, Lepold A, Tesfamichael D, Lasarev MR. Risk factors for enterococcal bacteriuria in dogs: A retrospective study. J Vet Intern Med 2020; 34:2447-2453. [PMID: 33009682 PMCID: PMC7694861 DOI: 10.1111/jvim.15916] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 08/26/2020] [Accepted: 09/17/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND In humans, Enterococcus spp. urinary tract infections (UTI) are commonly associated with urinary catheter-induced urothelial inflammation but this is not the case in dogs. HYPOTHESIS/OBJECTIVES To identify risk factors predisposing dogs to enterococcal bacteriuria. ANIMALS Seventy dogs with Enterococcus spp. bacteriuria (case) and 70 dogs with Enterococcus coli bacteriuria (control). METHODS A single center retrospective case-control study with subjects and controls identified by a medical records search for Enterococcus spp. (subject) or E coli (control) bacteriuria from January 1, 2014 to December 31, 2017. Cases and controls were balanced with respect to average age and weight. Binary logistic regression was used to estimate and test whether the odds of having Enterococcus spp. bacteriuria (instead of E coli) were associated with the presence of any given characteristic. RESULTS A history of recurrent bacteriuria was significantly more common in Enterococcus spp. cases than in E coli controls (odds ratio [OR]: 2.07; 95% confidence interval [CI]: 1.04-4.16, P = .04). Comorbidities associated with the presence of Enterococcus spp. bacteriuria included lower urinary tract (LUT) anatomic abnormalities (OR: 2.94; 95% CI: 1.17-8.10, P = .02), urolithiasis (P = .01), and the presence of LUT neoplasia (P = .04). Small frequencies (n = 12 and n = 6, respectively) compromise our ability to precisely estimate the genuine OR for the latter 2 characteristics. CONCLUSIONS AND CLINICAL IMPORTANCE If the identified risk factors promote Enterococcus spp. colonization in dogs via induced LUT inflammation similar to people then Enterococcus spp. bacteriuria could be a sentinel for underlying LUT inflammation.
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Affiliation(s)
- Michael W Wood
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Adam Lepold
- School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Dahlia Tesfamichael
- College of Letters and Science, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Michael R Lasarev
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Davedow T, Narvaez-Bravo C, Zaheer R, Sanderson H, Rodas-Gonzalez A, Klima C, Booker CW, Hannon SJ, Bras AL, Gow S, McAllister T. Investigation of a Reduction in Tylosin on the Prevalence of Liver Abscesses and Antimicrobial Resistance in Enterococci in Feedlot Cattle. Front Vet Sci 2020; 7:90. [PMID: 32185186 PMCID: PMC7059211 DOI: 10.3389/fvets.2020.00090] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 02/07/2020] [Indexed: 12/29/2022] Open
Abstract
Recent concerns over linkages between antimicrobial resistance in human pathogens and antimicrobial use in livestock have prompted researchers to investigate management strategies that reduce the current reliance on in-feed tylosin to control liver abscesses in feedlot cattle. A total of 7,576 crossbred yearlings were allocated to the study (~253 animals/pen, 10 replicate pens per treatment) and individually randomized to one of three treatments. Tylosin phosphate (11 ppm) was included in-feed (1) for the first 125 days on feed (DOF) (FIRST-78%), (2) for DOF 41 to 161 (LAST-75%), or (3) for the entire feeding period (CON; day 0–161). Fecal composites were collected from the pen floor on days 0, 81, and 160 of the finishing period. Serial dilutions were spread plated for enumeration of enterococci on Bile Esculin Azide (BEA) agar and BEA amended with 8 μg/ml erythromycin. Results indicated that although the proportion of EryR enterococci increased with DOF (P < 0.01), neither treatment (P = 0.34) or treatment × DOF (P = 0.37) affected antimicrobial resistance. Of the 538 isolates, 97% were enterococci, with mixed species isolated early in the feeding period and only Enterococcus hirae isolated at the end. Isolates were most frequently resistant to tylosin (86%), erythromycin (84%), and doxycycline (31%). Macrolide and tetracycline resistant isolates harbored erm(B), msrC, and tet(L), tet(M), tet(O) genes, respectively. Overall, the proportion of EryR enterococci increased (P < 0.05) in all three treatments over the feeding period. Compared to the control cattle, FIRST-78% cattle had more severe (P < 0.05) liver abscesses, while there was a trend (P < 0.08) for this response in LAST-75% cattle. There was no difference (P > 0.05) in total liver abscesses, growth performance, carcass traits, morbidity, or mortality among treatments. These results support the potential to reduce the duration and therefore quantity of tylosin administered to feedlot cattle during the feeding period without impacting animal productivity.
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Affiliation(s)
- Taylor Davedow
- Food and Human Nutritional Sciences Department, University of Manitoba, Winnipeg, MB, Canada.,Lethbridge Research and Development Centre, Agriculture and Agri-Food Canada, Lethbridge, AB, Canada
| | - Claudia Narvaez-Bravo
- Food and Human Nutritional Sciences Department, University of Manitoba, Winnipeg, MB, Canada
| | - Rahat Zaheer
- Lethbridge Research and Development Centre, Agriculture and Agri-Food Canada, Lethbridge, AB, Canada
| | - Haley Sanderson
- Lethbridge Research and Development Centre, Agriculture and Agri-Food Canada, Lethbridge, AB, Canada
| | - Argenis Rodas-Gonzalez
- Food and Human Nutritional Sciences Department, University of Manitoba, Winnipeg, MB, Canada
| | - Cassidy Klima
- Food and Human Nutritional Sciences Department, University of Manitoba, Winnipeg, MB, Canada.,Feedlot Health Management Services, Okotoks, AB, Canada
| | | | | | - Ana L Bras
- Feedlot Health Management Services, Okotoks, AB, Canada
| | - Sheryl Gow
- Public Health Agency of Canada, Saskatoon, SK, Canada
| | - Tim McAllister
- Lethbridge Research and Development Centre, Agriculture and Agri-Food Canada, Lethbridge, AB, Canada
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Jin M, Li D, Ji R, Liu W, Xu X, Li Y. Changes in intestinal microflora in digestive tract diseases during pregnancy. Arch Gynecol Obstet 2019; 301:243-249. [PMID: 31776707 PMCID: PMC7028802 DOI: 10.1007/s00404-019-05336-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 10/15/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE This study aimed to investigate the gut microbiome composition in pregnant women with digestive diseases to analyze the relationships between the microflora changes and digestive diseases during pregnancy. METHODS Fecal samples obtained from 71 pregnant women [six acute fatty liver (AF group), 21 constipation (C group), 24 excessive vomiting (V group) and 20 normal pregnancy (CP group)] and 26 non-pregnant (NP group) women were subjected to 16 s rRNA sequencing. Differential analysis of intestinal flora at the genera level was performed. RESULTS The relative abundance of Coprobacillus, Acinetobacter, Enterococcus, Weissella and Lysinibacillus was increased in the digestive diseases (AF, C and V) groups compared with CP group, whereas that of five common genera, including Terrisporobacter, Dysgonomonas, Adlercreutzia, Fusicatenibacter and Blautia, was decreased in digestive diseases groups. Additionally, in digestive diseases (AF, C and V) groups, the abundance of 13 common genera, such as Carnobacterium, Coprobacillus and Psychrobacter, was higher than NP group, whereas that of 27 common genera, such as Blautia and Terrisporobacter, was lower than NP group. About 69 genera were differentially abundant between AF and C groups; two genera (Aerococcus and Senegalimassilia) were identified between AF and V groups; moreover, total 63 genera were obtained between C and V groups. CONCLUSION Our data revealed that the abundance of Acinetobacter, Enterococci, Paenibacillus, Blautia and Collinsella might be associated with the digestive diseases during pregnancy. These findings further supported the idea that targeting the gut microbiota could be a new prevention or therapeutic approach for improving digestive diseases during pregnancy.
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Affiliation(s)
- Min Jin
- Department of Anesthesiology, Qilu Hospital, Shandong University, Jinan, 250012, Shandong, China
| | - Dong Li
- Stem Cell and Regenerative Medicine Center of Shandong University, Jinan, 250012, Shandong, China
| | - Rui Ji
- Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, 250012, Shandong, China
| | - Wen Liu
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Qilu Hospital, Shandong University, Jinan, 250012, Shandong, China
| | - Xiaofei Xu
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Qilu Hospital, Shandong University, Jinan, 250012, Shandong, China
| | - Yanqing Li
- Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital, Shandong University, Jizhong Building, 107 Wen hua Xi Road, Lixia District, Jinan, 250012, Shandong, China.
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12
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Weng PL, Ramli R, Hamat RA. Antibiotic Susceptibility Patterns, Biofilm Formation and esp Gene among Clinical Enterococci: Is There Any Association? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16183439. [PMID: 31533204 PMCID: PMC6765802 DOI: 10.3390/ijerph16183439] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/19/2019] [Accepted: 08/20/2019] [Indexed: 12/14/2022]
Abstract
Enterococci are commonly found in humans, animals and environments. Their highly adaptive mechanisms are related to several virulent determinants and their ability to resist antibiotics. Data on the relationship between the esp gene, biofilm formation and antibiotic susceptibility profiles may differ between countries. This cross-sectional study was conducted to determine the proportion of esp gene and biofilm formation among Enterococcus faecalis and Enterococcus faecium clinical isolates. We also investigated the possible association between the esp gene with antibiotic susceptibility patterns and biofilm formation. The isolates were collected from clinical samples and identified using biochemical tests and 16SRNA. Antibiotic susceptibility patterns and a biofilm assay were conducted according to the established guidelines. Molecular detection by PCR was used to identify the esp gene using established primers. In total, 52 and 28 of E. faecalis and E. faecium were identified, respectively. E. faecium exhibited higher resistance rates compared to E. faecalis as follows: piperacillin/tazobactam (100% versus 1.9%), ampicillin (92.8% versus 1.9%), high-level gentamicin resistance (HLGR) (89.3% versus 25.0%) and penicillin (82.1% versus 7.7%). E. faecium produced more biofilms than E. faecalis (59.3% versus 49.0%). E. faecium acquired the esp gene more frequently than E. faecalis (78.6% versus 46.2%). Interestingly, the associations between ampicillin and tazobactam/piperacillin resistance with the esp gene were statistically significant (X2 = 4.581, p = 0.027; and X2 = 6.276, p = 0.012, respectively). Our results demonstrate that E. faecium exhibits high rates of antimicrobial resistance, esp gene acquisition and biofilm formation. These peculiar traits of E. faecium may have implications for the management of enterococcal infections in hospitals. Thus, concerted efforts by all parties in establishing appropriate treatment and effective control measures are warranted in future.
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Affiliation(s)
- Poh Leng Weng
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia.
| | - Ramliza Ramli
- Department of Medical Microbiology and Immunology, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaakob Latif, Bandar Tun Razak, Kuala Lumpur 56000, Malaysia.
| | - Rukman Awang Hamat
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia.
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Abstract
The emergence of antimicrobial drug resistance requires development of alternative therapeutic options. Multidrug-resistant strains of Enterococcus spp., Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumanii, Pseudomonas aeruginosa and Enterobacter spp. are still the most commonly identified antimicrobial-resistant pathogens. These microorganisms are part of the so-called 'ESKAPE' pathogens to emphasize that they currently cause the majority of hospital acquired infections and effectively 'escape' the effects of antibacterial drugs. Thus, alternative, safer and more efficient antimicrobial strategies are urgently needed, especially against 'ESKAPE' superbugs. Antimicrobial photodynamic inactivation is a therapeutic option used in the treatment of infectious diseases. It is based on a combination of a photosensitizer, light and oxygen to remove highly metabolically active cells.
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14
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Falcone M, Tiseo G, Dentali F, Foglia E, Campanini M, Menichetti F, Mazzone A. Early alert from the microbiology laboratory improves the outcome of elderly patients with Enterococcus spp. bloodstream infection: Results from a multicentre prospective study. J Glob Antimicrob Resist 2019; 18:139-144. [PMID: 30825701 DOI: 10.1016/j.jgar.2019.02.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 02/04/2019] [Accepted: 02/19/2019] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVES This study describes the clinical features and outcomes of patients with bloodstream infection (BSI) due to Enterococcus spp. and identified factors predictive of mortality. METHODS This analysis is part of a prospective multicentre observational study of consecutive hospitalised patients with BSI conducted from March 2012 to December 2012 in 31 internal medicine wards in Italy. Patients with enterococcal BSI were selected from the entire cohort. Patient characteristics, therapeutic interventions and outcome were reviewed. Cox regression analysis was performed to identify factors associated with in-hospital mortality. Hazard ratios (HRs) and 95% interval confidences (CIs) were calculated. RESULTS Among 533 patients with BSI, 41 (7.7%) had BSI by Enterococcus spp. (28 Enterococcus faecalis, 4 Enterococcus faecium and 3 each of Enterococcus avium, Enterococcus casseliflavus and Enterococcus gallinarum). Six BSIs (14.6%) were polymicrobial. Median (IQR) patient age was 73 (66-85.5) years. In-hospital mortality was 24.4%. Polymicrobial infection (HR = 9.100, 95% CI 1.295-63.949; P = 0.026), age (HR = 1.261, 95% CI 1.029-1.546; P = 0.025) and SOFA score (HR = 1.244, 95% CI 1.051-1.474; P = 0.011) were risk factors for in-hospital mortality. Conversely, receiving an alert from the microbiology laboratory before obtaining final antimicrobial susceptibility results was associated with survival (HR = 0.073, 95% CI 0.007-0.805; P = 0.033). CONCLUSION BSI due to Enterococcus spp. in elderly patients is associated with high mortality. Polymicrobial infection, age and SOFA score are factors associated with poor outcome. Conversely, early alert from the microbiology laboratory improves patient survival.
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Affiliation(s)
- M Falcone
- Division of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | - G Tiseo
- Department of Internal Medicine and Medical Specialties, 'Sapienza' University of Rome, Rome, Italy
| | - F Dentali
- Department of Clinical Medicine, University of Insubria, Varese, Italy
| | - E Foglia
- Centre for Research on Health Economics, Social and Health Care Management (CREMS), University Carlo Cattaneo-LIUC, Castellanza, Italy
| | - M Campanini
- Internal Medicine Ward, Ospedale Maggiore della Carità, Novara, Italy
| | - F Menichetti
- Division of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - A Mazzone
- Internal Medicine Ward, Ospedale Civile, Legnano, Italy
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15
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Scheich S, Weber S, König R, Wilke AC, Lindner S, Reinheimer C, Wichelhaus TA, Hogardt M, A J Kempf V, Kessel J, Martin H, Bug G, Serve H, Steffen B. Timepoints of vancomycin-resistant Enterococcus colonization predict outcomes of acute myeloid leukemia patients undergoing allogeneic hematopoietic cell transplantation. Eur J Haematol 2018; 101:620-629. [PMID: 30048011 DOI: 10.1111/ejh.13151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 07/16/2018] [Accepted: 07/20/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND In hematology and oncology, in particular in the setting of allogeneic hematopoietic stem cell transplantation (allo-HSCT), vancomycin-resistant Enterococcus spp. (VRE) colonization rates are high due to previous hospital stays and preceding antibiotic treatment and colonized patients have a lower overall survival (OS). OBJECTIVE We reanalyzed our previously published cohort, to unravel which colonization timepoints before and during allo-HSCT might be predictive for the subsequent outcome. PATIENTS AND METHODS We report about 268 patients with acute myeloid leukemia receiving an allo-HSCT between 2006 and 2016. RESULTS We identified 129 never-colonized patients, 15 previously colonized patients (positive only before admission for allo-HSCT), 41 persistently colonized patients (positive before and at admission for allo-HSCT), and 83 newly colonized patients (positive only during allo-HSCT). Persistently and newly colonized patients had a worse 60 months OS due to increased incidence of non-relapse-related mortality (NRM) than never-colonized patients (OS: never-colonized: 61.0% vs persistently colonized: 43.5%; P = 0.023 vs newly colonized: 45.6%; P = 0.046). In contrast, OS and NRM of never-colonized and previously colonized patients as well as between persistently and newly colonized patients were similar. CONCLUSION Patients can lose their VRE colonization status and acquisition of VRE during inpatient stay for allo-HSCT decreases survival to a similar extend as persistent colonization.
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Affiliation(s)
- Sebastian Scheich
- Department of Hematology and Oncology, University Hospital Frankfurt, Frankfurt am Main, Germany
- University Center for Infectious Diseases, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Sarah Weber
- Department of Hematology and Oncology, University Hospital Frankfurt, Frankfurt am Main, Germany
- University Center for Infectious Diseases, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Rosalie König
- Department of Hematology and Oncology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Anne C Wilke
- Department of Hematology and Oncology, University Hospital Frankfurt, Frankfurt am Main, Germany
- University Center for Infectious Diseases, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Sarah Lindner
- Department of Hematology and Oncology, University Hospital Frankfurt, Frankfurt am Main, Germany
- University Center for Infectious Diseases, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Claudia Reinheimer
- University Center for Infectious Diseases, University Hospital Frankfurt, Frankfurt am Main, Germany
- Institute for Medical Microbiology and Infection Control, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Thomas A Wichelhaus
- University Center for Infectious Diseases, University Hospital Frankfurt, Frankfurt am Main, Germany
- Institute for Medical Microbiology and Infection Control, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Michael Hogardt
- University Center for Infectious Diseases, University Hospital Frankfurt, Frankfurt am Main, Germany
- Institute for Medical Microbiology and Infection Control, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Volkhard A J Kempf
- University Center for Infectious Diseases, University Hospital Frankfurt, Frankfurt am Main, Germany
- Institute for Medical Microbiology and Infection Control, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Johanna Kessel
- University Center for Infectious Diseases, University Hospital Frankfurt, Frankfurt am Main, Germany
- Infectious Diseases Unit, Department of Medicine, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Hans Martin
- Department of Hematology and Oncology, University Hospital Frankfurt, Frankfurt am Main, Germany
- University Center for Infectious Diseases, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Gesine Bug
- Department of Hematology and Oncology, University Hospital Frankfurt, Frankfurt am Main, Germany
- University Center for Infectious Diseases, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Hubert Serve
- Department of Hematology and Oncology, University Hospital Frankfurt, Frankfurt am Main, Germany
- University Center for Infectious Diseases, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Björn Steffen
- Department of Hematology and Oncology, University Hospital Frankfurt, Frankfurt am Main, Germany
- University Center for Infectious Diseases, University Hospital Frankfurt, Frankfurt am Main, Germany
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16
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Enterococci and pseudomonads as quality indicators in industrial production and storage of mozzarella cheese from raw cow milk. Int Dairy J 2018. [DOI: 10.1016/j.idairyj.2018.02.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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17
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Shettigar K, Bhat DV, Satyamoorthy K, Murali TS. Severity of drug resistance and co-existence of Enterococcus faecalis in diabetic foot ulcer infections. Folia Microbiol (Praha) 2017; 63:115-122. [PMID: 28889401 DOI: 10.1007/s12223-017-0547-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 09/01/2017] [Indexed: 01/04/2023]
Abstract
The genes encoding aminoglycoside resistance in Enterococcus faecalis may promote collateral aminoglycoside resistance in polymicrobial wounds. We studied a total of 100 diabetic foot ulcer samples for infection and found 60 samples to be polymicrobial, 5 to be monomicrobial, and 35 samples to be culture negative. A total of 65 E. faecalis isolates were screened for six genes coding for aminoglycoside resistance, antibiotic resistance patterns, and biofilm production. Infectious Diseases Society of America/International Working Group on the Diabetic Foot system was used to classify the wound ulcers. Majority of the subjects with culture-positive wound were recommended conservative management, while 14 subjects underwent amputation. Enterococcal isolates showed higher resistance for erythromycin, tetracycline, and ciprofloxacin. Isolates from grade 3 ulcer showed higher frequency of aac(6')-Ie-aph(2″)-Ia, while all the isolates were negative for aph(2″)-Ib, aph(2″)-Ic, and aph(2″)-Id. The isolates from grade 3 ulcers showed higher resistance to aminoglycosides as well as teicoplanin and chloramphenicol. All the 39 biofilm producers were obtained from polymicrobial wound and showed higher resistance when compared to biofilm non-producers. Higher frequency of isolates carrying aac(6')-Ie-aph(2″)-Ia in polymicrobial community showing resistance to key antibiotics suggests widespread distribution of aminoglycoside-resistant E. faecalis and their role in worsening diabetic foot ulcers.
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Affiliation(s)
- Kavitha Shettigar
- Department of Biotechnology, School of Life Sciences, Manipal University, Manipal, 576104, India
| | - Deepika V Bhat
- Department of Biotechnology, School of Life Sciences, Manipal University, Manipal, 576104, India
| | - Kapaettu Satyamoorthy
- Department of Cellular and Molecular Biology, School of Life Sciences, Manipal University, Manipal, 576104, India
| | - Thokur Sreepathy Murali
- Department of Biotechnology, School of Life Sciences, Manipal University, Manipal, 576104, India.
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18
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Brauner P, Gromöller S, Pfeifer Y, Wilharm G, Jäckel U. Hatchery workers’ IgG antibody profiles to airborne bacteria. Int J Hyg Environ Health 2017; 220:431-439. [DOI: 10.1016/j.ijheh.2016.12.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 12/08/2016] [Accepted: 12/20/2016] [Indexed: 10/20/2022]
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Beukers AG, Zaheer R, Goji N, Amoako KK, Chaves AV, Ward MP, McAllister TA. Comparative genomics of Enterococcus spp. isolated from bovine feces. BMC Microbiol 2017; 17:52. [PMID: 28270110 PMCID: PMC5341189 DOI: 10.1186/s12866-017-0962-1] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 02/21/2017] [Indexed: 01/18/2023] Open
Abstract
Background Enterococcus is ubiquitous in nature and is a commensal of both the bovine and human gastrointestinal (GI) tract. It is also associated with clinical infections in humans. Subtherapeutic administration of antibiotics to cattle selects for antibiotic resistant enterococci in the bovine GI tract. Antibiotic resistance genes (ARGs) may be present in enterococci following antibiotic use in cattle. If located on mobile genetic elements (MGEs) their dissemination between Enterococcus species and to pathogenic bacteria may be promoted, reducing the efficacy of antibiotics. Results We present a comparative genomic analysis of twenty-one Enterococcus spp. isolated from bovine feces including Enterococcus hirae (n = 10), Enterococcus faecium (n = 3), Enterococcus villorum (n = 2), Enterococcus casseliflavus (n = 2), Enterococcus faecalis (n = 1), Enterococcus durans (n = 1), Enterococcus gallinarum (n = 1) and Enterococcus thailandicus (n = 1). The analysis revealed E. faecium and E. faecalis from bovine feces share features with human clinical isolates, including virulence factors. The Tn917 transposon conferring macrolide-lincosamide-streptogramin B resistance was identified in both E. faecium and E. hirae, suggesting dissemination of ARGs on MGEs may occur in the bovine GI tract. An E. faecium isolate was also identified with two integrative conjugative elements (ICEs) belonging to the Tn916 family of ICE, Tn916 and Tn5801, both conferring tetracycline resistance. Conclusions This study confirms the presence of enterococci in the bovine GI tract possessing ARGs on MGEs, but the predominant species in cattle, E. hirae is not commonly associated with infections in humans. Analysis using additional complete genomes of E. faecium from the NCBI database demonstrated differential clustering of commensal and clinical isolates, suggesting that these strains may be specifically adapted to their respective environments. Electronic supplementary material The online version of this article (doi:10.1186/s12866-017-0962-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alicia G Beukers
- Faculty of Veterinary Science, School of Life and Environmental Sciences, The University of Sydney, Sydney, NSW, Australia.,Lethbridge Research Centre, Agriculture and Agri-Food Canada, Lethbridge, AB, Canada
| | - Rahat Zaheer
- Lethbridge Research Centre, Agriculture and Agri-Food Canada, Lethbridge, AB, Canada
| | - Noriko Goji
- Canadian Food Inspection Agency, National Center for Animal Disease, Lethbridge Laboratory, Lethbridge, AB, Canada
| | - Kingsley K Amoako
- Canadian Food Inspection Agency, National Center for Animal Disease, Lethbridge Laboratory, Lethbridge, AB, Canada
| | - Alexandre V Chaves
- Faculty of Veterinary Science, School of Life and Environmental Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Michael P Ward
- Faculty of Veterinary Science, School of Life and Environmental Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Tim A McAllister
- Lethbridge Research Centre, Agriculture and Agri-Food Canada, Lethbridge, AB, Canada.
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20
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Maiti TK, Nagarathna S, Kumari HBV, Shukla DP. A series of enterococcal brain abscesses. J Neurosci Rural Pract 2015; 6:434-7. [PMID: 26167038 PMCID: PMC4481809 DOI: 10.4103/0976-3147.158774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: Neurosurgeons in developing countries come across brain abscess frequently, but Enterococcus as a cause of abscess is rare. Aims: To describe clinical profile and treatment of a series of patients with enterococcal brain abscess. Materials and Methods: We retrospectively reviewed microbiological records of patients with brain abscess to identify Enterococcus as a causative organism. Results: 12 patients (nine males) were diagnosed to have enterococcal brain abscess. All were due to E. species. Conclusions: The clinical feature and management are not different from other etiological agents. The prognosis of enterococcal brain abscess is more favourable than bacteremia.
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Affiliation(s)
- Tanmoy K Maiti
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - S Nagarathna
- Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - H B Veena Kumari
- Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Dhaval P Shukla
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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21
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Beukers AG, Zaheer R, Cook SR, Stanford K, Chaves AV, Ward MP, McAllister TA. Effect of in-feed administration and withdrawal of tylosin phosphate on antibiotic resistance in enterococci isolated from feedlot steers. Front Microbiol 2015; 6:483. [PMID: 26074889 PMCID: PMC4444845 DOI: 10.3389/fmicb.2015.00483] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 05/02/2015] [Indexed: 12/24/2022] Open
Abstract
Tylosin phosphate is a macrolide commonly administered to cattle in North America for the control of liver abscesses. This study investigated the effect of in-feed administration of tylosin phosphate to cattle at subtherapeutic levels and its subsequent withdrawal on macrolide resistance using enterococci as an indicator bacterium. Fecal samples were collected from steers that received no antibiotics and steers administered tylosin phosphate (11 ppm) in-feed for 197 days and withdrawn 28 days before slaughter. Enterococcus species isolated from fecal samples were identified through sequencing the groES-EL intergenic spacer region and subject to antimicrobial susceptibility testing, identification of resistance determinants and pulsed-field gel electrophoresis profiling. Tylosin increased (P < 0.05) the proportion of eryR and tylR enterococci within the population. Just prior to its removal, the proportion of eryR and tylR resistant enterococci began decreasing and continued to decrease after tylosin was withdrawn from the diet until there was no difference (P > 0.05) between treatments on d 225. This suggests that antibiotic withdrawal prior to slaughter contributes to a reduction in the proportion of macrolide resistant enterococci entering the food chain. Among the 504 enterococci isolates characterized, Enterococcus hirae was found to predominate (n = 431), followed by Enterococcus villorum (n = 32), Enterococcus faecium (n = 21), Enterococcus durans (n = 7), Enterococcus casseliflavus (n = 4), Enterococcus mundtii (n = 4), Enterococcus gallinarum (n = 3), Enterococcus faecalis (n = 1), and Enterococcus thailandicus (n = 1). The diversity of enterococci was greater in steers at arrival than at exit from the feedlot. Erythromycin resistant isolates harbored the erm(B) and/or msrC gene. Similar PFGE profiles of eryRE. hirae pre- and post-antibiotic treatment suggest that increased abundance of eryR enterococci after administration of tylosin phosphate reflects selection for strains that were already present within the gastrointestinal tract of cattle at arrival.
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Affiliation(s)
- Alicia G Beukers
- Faculty of Veterinary Science, The University of Sydney Sydney, NSW, Australia ; Lethbridge Research Centre, Agriculture and Agri-Food Canada Lethbridge, AB, Canada
| | - Rahat Zaheer
- Lethbridge Research Centre, Agriculture and Agri-Food Canada Lethbridge, AB, Canada
| | - Shaun R Cook
- Lethbridge Research Centre, Agriculture and Agri-Food Canada Lethbridge, AB, Canada
| | - Kim Stanford
- Alberta Agriculture and Rural Development, Lethbridge Research Centre Lethbridge, AB, Canada
| | - Alexandre V Chaves
- Faculty of Veterinary Science, The University of Sydney Sydney, NSW, Australia
| | - Michael P Ward
- Faculty of Veterinary Science, The University of Sydney Sydney, NSW, Australia
| | - Tim A McAllister
- Lethbridge Research Centre, Agriculture and Agri-Food Canada Lethbridge, AB, Canada
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Iweriebor BC, Gaqavu S, Obi LC, Nwodo UU, Okoh AI. Antibiotic susceptibilities of enterococcus species isolated from hospital and domestic wastewater effluents in alice, eastern cape province of South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:4231-46. [PMID: 25893999 PMCID: PMC4410244 DOI: 10.3390/ijerph120404231] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 03/24/2015] [Accepted: 04/08/2015] [Indexed: 01/12/2023]
Abstract
Background: Antimicrobial resistance in microorganisms are on the increase worldwide and are responsible for substantial cases of therapeutic failures. Resistance of species of Enterococcus to antibiotics is linked to their ability to acquire and disseminate antimicrobial resistance determinants in nature, and wastewater treatment plants (WWTPs) are considered to be one of the main reservoirs of such antibiotic resistant bacteria. We therefore determined the antimicrobial resistance and virulence profiles of some common Enterococcus spp that are known to be associated with human infections that were recovered from hospital wastewater and final effluent of the receiving wastewater treatment plant in Alice, Eastern Cape. Methods: Wastewater samples were simultaneously collected from two sites (Victoria hospital and final effluents of a municipal WWTP) in Alice at about one to two weeks interval during the months of July and August 2014. Samples were screened for the isolation of enterococci using standard microbiological methods. The isolates were profiled molecularly after targeted generic identification and speciation for the presence of virulence and antibiotic resistance genes. Results: Out of 66 presumptive isolates, 62 were confirmed to belong to the Enterococcus genusof which 30 were identified to be E. faecalis and 15 E. durans. The remaining isolates were not identified by the primers used in the screening procedure. Out of the six virulence genes that were targeted only three of them; ace, efaA, and gelE were detected. There was a very high phenotypic multiple resistance among the isolates and these were confirmed by genetic analyses. Conclusions: Analyses of the results obtained indicated that hospital wastewater may be one of the sources of antibiotic resistant bacteria to the receiving WWTP. Also, findings revealed that the final effluent discharged into the environment was contaminated with multi-resistant enterococci species thus posing a health hazard to the receiving aquatic environment as these could eventually be transmitted to humans and animals that are exposed to it.
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Affiliation(s)
- Benson Chuks Iweriebor
- SA-MRC Microbial Water Quality Monitoring Centre, University of Fort Hare,1 King Williams Town Road, Alice 5700, South Africa.
- Applied and Environmental Microbiology Research Group, Department of Biochemistry and Microbiology, University of Fort Hare, 1 King Williams Town Road, Alice 5700, South Africa.
| | - Sisipho Gaqavu
- SA-MRC Microbial Water Quality Monitoring Centre, University of Fort Hare,1 King Williams Town Road, Alice 5700, South Africa.
- Applied and Environmental Microbiology Research Group, Department of Biochemistry and Microbiology, University of Fort Hare, 1 King Williams Town Road, Alice 5700, South Africa.
| | - Larry Chikwelu Obi
- Academic and Research Division, University of Fort Hare, King Williams Road, Alice 5700 Eastern Cape, South Africa.
| | - Uchechukwu U Nwodo
- SA-MRC Microbial Water Quality Monitoring Centre, University of Fort Hare,1 King Williams Town Road, Alice 5700, South Africa.
- Applied and Environmental Microbiology Research Group, Department of Biochemistry and Microbiology, University of Fort Hare, 1 King Williams Town Road, Alice 5700, South Africa.
| | - Anthony I Okoh
- SA-MRC Microbial Water Quality Monitoring Centre, University of Fort Hare,1 King Williams Town Road, Alice 5700, South Africa.
- Applied and Environmental Microbiology Research Group, Department of Biochemistry and Microbiology, University of Fort Hare, 1 King Williams Town Road, Alice 5700, South Africa.
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EC300: a phage-based, bacteriolysin-like protein with enhanced antibacterial activity against Enterococcus faecalis. Appl Microbiol Biotechnol 2015; 99:5137-49. [DOI: 10.1007/s00253-015-6483-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Revised: 02/12/2015] [Accepted: 02/13/2015] [Indexed: 10/23/2022]
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Cationic antimicrobial peptides as potential new therapeutic agents in neonates and children: a review. Curr Opin Infect Dis 2015; 27:258-67. [PMID: 24722240 DOI: 10.1097/qco.0000000000000057] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW Antimicrobial resistance towards conventional antibiotics is a serious problem for modern medicine and for our society. Multidrug-resistant bacteria are very difficult to treat and treatment options have begun to run out. Here, we summarize the newest studies of drug development using cationic antimicrobial peptides as lead molecules for novel antimicrobial drugs. RECENT FINDINGS A new development is the use of antimicrobial peptides not only as direct antimicrobial lead structures but also using their ability to influence the immune system. Such approaches can be used to develop drugs that influence the immune system in a unique way, supporting specific branches of immune cells in order to clear infection. Applying such an 'immune boost' would also minimize the danger of new resistance emerging in bacteria. In addition, searching for and testing substances that trigger the production of host antimicrobial peptides is still ongoing and opens up a totally new avenue for the use of antimicrobial peptides against infections. Currently, more than 10 clinical trials, phase 2 or 3, using antimicrobial peptides are in progress or have been recently completed. SUMMARY Multidrug resistance is an urgent problem for modern medicine and novel antimicrobials are needed. Despite some drawbacks, antimicrobial peptides seem now to appear more numerous in clinical trials, indicating the success in developing peptides into novel therapeutics. This can be critical especially for neonates and children, as treatment options for infections with Gram-negatives in neonatal ICUs are becoming rare.
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Lavilla Lerma L, Benomar N, Valenzuela AS, Casado Muñoz MDC, Gálvez A, Abriouel H. Role of EfrAB efflux pump in biocide tolerance and antibiotic resistance of Enterococcus faecalis and Enterococcus faecium isolated from traditional fermented foods and the effect of EDTA as EfrAB inhibitor. Food Microbiol 2014; 44:249-57. [PMID: 25084670 DOI: 10.1016/j.fm.2014.06.009] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Revised: 05/15/2014] [Accepted: 06/11/2014] [Indexed: 11/30/2022]
Abstract
Enterococcus faecalis and Enterococcus faecium isolated from various traditional fermented foods of both animal and vegetable origins have shown multidrug resistance to several antibiotics and tolerance to biocides. Reduced susceptibility was intra and inter-species dependent and was due to specific and unspecific mechanisms such as efflux pumps. EfrAB, a heterodimeric ABC transporter efflux pump, was detected in 100% of multidrug resistant (MDR) E. faecalis strains and only in 12% of MDR E. faecium strains. EfrAB expression was induced by half of minimum inhibitory concentration (MIC) of gentamicin, streptomycin and chloramphenicol. However, expression of efrA and efrB genes was highly dependent on the strain tested and on the antimicrobial used. Our results indicated that 3 mM EDTA highly reduced the MICs of almost all drugs tested. Nevertheless, the higher reductions (>8 folds) were obtained with gentamicin, streptomycin, chlorhexidine and triclosan. Reductions of MICs were correlated with down-regulation of EfrAB expression (10-140 folds) in all three MDR enterococci strains. This is the first report describing the role of EfrAB in the efflux of antibiotics and biocides which reflect also the importance of EfrAB in multidrug resistance in enterococci. EDTA used at low concentration as food preservative could be one of the best choices to prevent spread of multidrug resistant enterococci throughout food chain by decreasing EfrAB expression. EfrAB could be an attractive target not only in enterococci present in food matrix but also those causing infections as well by using EDTA as therapeutic agent in combination with low doses of antibiotics.
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Affiliation(s)
- Leyre Lavilla Lerma
- Área de Microbiología, Departamento de Ciencias de la Salud, Facultad de Ciencias Experimentales, Universidad de Jaén, 23071 Jaén, Spain
| | - Nabil Benomar
- Área de Microbiología, Departamento de Ciencias de la Salud, Facultad de Ciencias Experimentales, Universidad de Jaén, 23071 Jaén, Spain
| | - Antonio Sánchez Valenzuela
- Área de Microbiología, Departamento de Ciencias de la Salud, Facultad de Ciencias Experimentales, Universidad de Jaén, 23071 Jaén, Spain
| | - María del Carmen Casado Muñoz
- Área de Microbiología, Departamento de Ciencias de la Salud, Facultad de Ciencias Experimentales, Universidad de Jaén, 23071 Jaén, Spain
| | - Antonio Gálvez
- Área de Microbiología, Departamento de Ciencias de la Salud, Facultad de Ciencias Experimentales, Universidad de Jaén, 23071 Jaén, Spain
| | - Hikmate Abriouel
- Área de Microbiología, Departamento de Ciencias de la Salud, Facultad de Ciencias Experimentales, Universidad de Jaén, 23071 Jaén, Spain.
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Abstract
Oxygen and oxidative stress have become relevant components in clarifying the mechanism that weakens bacterial cells in parallel to the mode of action of bactericidal antibiotics. Given the importance of oxidative stress in the overall defense mechanism of bacteria and their apparent role in the antimicrobial mode of action, it is important to understand how bacteria respond to this stress at a metabolic level. The aim of this study was to determine the impact of oxygen on the metabolism of the facultative anaerobe Enterococcus faecalis using continuous culture, metabolomics, and (13)C enrichment of metabolic intermediates. When E. faecalis was rapidly transitioned from anaerobic to aerobic growth, cellular metabolism was directed toward intracellular glutathione production and glycolysis was upregulated 2-fold, which increased the supply of critical metabolite precursors (e.g., glycine and glutamate) for sulfur metabolism and glutathione biosynthesis as well as reducing power for cellular respiration in the presence of hemin. The ultimate metabolic response of E. faecalis to an aerobic environment was the upregulation of fatty acid metabolism and benzoate degradation, which was linked to important changes in the bacterial membrane composition as evidenced by changes in membrane fatty acid composition and the reduction of membrane-associated demethylmenaquinone. These key metabolic pathways associated with the response of E. faecalis to oxygen may represent potential new targets to increase the susceptibility of this bacterium to bactericidal drugs.
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27
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Mohee AR, West R, Baig W, Eardley I, Sandoe JAT. A case-control study: are urological procedures risk factors for the development of infective endocarditis? BJU Int 2014; 114:118-24. [PMID: 24180426 DOI: 10.1111/bju.12550] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To evaluate the association between urological procedures and the development of infective endocarditis (IE), as there are case-reports linking urological procedures to IE but evidence of a causal relationship is lacking and no major guidelines advise prophylaxis to prevent development of IE during transurethral urological procedures. No case-control study has been undertaken to examine the relationship between urological procedures and the development of IE. PATIENTS AND METHODS Retrospective evaluation of the IE database at our institution. The population consisted of patients diagnosed with enterococcal, staphylococcal, Streptococcus bovis-group and oral streptococcal IE over a 10-year period. Possible risk factors for the development of IE, including urological procedures were collected. A case-control design was used and univariable and multivariable analyses were carried out. Missing data was accounted for using the multiple imputations method. RESULTS We included 384 patients with IE. There was a statistical association between the development of enterococcal IE and preceding urological procedures (odds ratio 8.21, 95% confidence interval 3.54-19.05, P < 0.05). Increasing age and being an intravenous drug user were also associated with enterococcal IE. Haemodialysis and the presence of an intracardiac device were associated with the development of coagulase-negative staphyloccal IE. CONCLUSION This is the first study to show a statistical association between urological procedures and the development of IE. The bacteraemia leading to IE may be a result of the urological procedures or a consequence of the underlying urological pathology causing recurrent subclinical bacteraemias.
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Affiliation(s)
- Amar R Mohee
- Department of Urology, The Salford Royal NHS Trust, Salford, UK
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Dahl A, Bruun NE. Enterococcus faecalisinfective endocarditis: focus on clinical aspects. Expert Rev Cardiovasc Ther 2014; 11:1247-57. [DOI: 10.1586/14779072.2013.832482] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Padilla C, Lobos O. Virulence, bacterocin genes and antibacterial susceptibility in Enterococcus faecalis strains isolated from water wells for human consumption. SPRINGERPLUS 2013; 2:43. [PMID: 23449751 PMCID: PMC3579423 DOI: 10.1186/2193-1801-2-43] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Accepted: 01/31/2013] [Indexed: 11/10/2022]
Abstract
The objectives of this study were to detect genes for virulence and bacteriocins in addition to studying the antimicrobial susceptibility of 78 strains of E. faecalis isolated from water wells for human consumption. The virulence and bacteriocin genes of 78 E. faecalis were amplified by PCR and visualized in agarose gels. The antimicrobial susceptibility was determined through diffusion agar tests and the MIC through microdilution. It was observed that the major percentage of virulence genes in the E. faecalis strains corresponds to aggA (93.5%). The bacteriocin gene entA (64.1%) is the most frequently detected. The studied strains exhibited different virulence and bacteriocin genes, and an important antibacterial resistance. The most common resistant phenotype (n = 14) corresponds to tetracycline and chloramphenicol and the less frequent (n = 2) to ciprofloxacin and moxifloxacin. Eight different genetic profiles were observed for virulence y bacteriocin genes. It was determined a statistical association between the bacterial resistance and some of the genetic profiles detected.
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Affiliation(s)
- Carlos Padilla
- Departamento de Microbiología, Universidad de Talca, Talca Camino Lircay s/n, Talca, Chile
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Abstract
Treatment of enterococcal infections has long been recognized as an important clinical challenge, particularly in the setting of infective endocarditis (IE). Furthermore, the increase prevalence of isolates exhibiting multidrug resistance (MDR) to traditional anti-enterococcal antibiotics such as ampicillin, vancomycin and aminoglycosides (high-level resistance) poses immense therapeutic dilemmas in hospitals around the world. Unlike IE caused by most isolates of Enterococcus faecalis, which still retain susceptibility to ampicillin and vancomycin, the emergence and dissemination of a hospital-associated genetic clade of multidrug resistant Enterococcus faecium, markedly limits the therapeutic options. The best treatment of IE MDR enterococcal endocarditis is unknown and the paucity of antibiotics with bactericidal activity against these organisms is a cause of serious concern. Although it appears that we are winning the war against E. faecalis, the battle rages on against isolates of multidrug-resistant E. faecium.
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Proença D, Fernandes S, Leandro C, Silva FA, Santos S, Lopes F, Mato R, Cavaco-Silva P, Pimentel M, São-José C. Phage Endolysins with Broad Antimicrobial Activity AgainstEnterococcus faecalisClinical Strains. Microb Drug Resist 2012; 18:322-32. [DOI: 10.1089/mdr.2012.0024] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Sofia Fernandes
- Technophage, SA, Lisboa, Portugal
- Centro de Patogénese Molecular, Unidade de Retrovírus e Infecções Associadas (CPM-URIA), Faculdade de Farmácia da Universidade de Lisboa, Lisboa, Portugal
| | | | | | - Sofia Santos
- Instituto de Biologia Experimental e Tecnológica (IBET), Oeiras, Portugal
- Instituto de Tecnologia Química e Biológica (ITQB), Universidade Nova de Lisboa, Oeiras, Portugal
| | - Fátima Lopes
- Instituto de Biologia Experimental e Tecnológica (IBET), Oeiras, Portugal
- Instituto de Tecnologia Química e Biológica (ITQB), Universidade Nova de Lisboa, Oeiras, Portugal
| | - Rosario Mato
- Laboratory of Molecular Genetics, Instituto de Tecnologia Química e Biológica (ITQB), Universidade Nova de Lisboa, Oeiras, Portugal
- Dept. de Ciências da Vida da Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Monte de Caparica, Portugal
| | - Patrícia Cavaco-Silva
- Technophage, SA, Lisboa, Portugal
- Center for Interdisciplinary Research Egas Moniz, Monte de Caparica, Portugal
| | - Madalena Pimentel
- Centro de Patogénese Molecular, Unidade de Retrovírus e Infecções Associadas (CPM-URIA), Faculdade de Farmácia da Universidade de Lisboa, Lisboa, Portugal
| | - Carlos São-José
- Centro de Patogénese Molecular, Unidade de Retrovírus e Infecções Associadas (CPM-URIA), Faculdade de Farmácia da Universidade de Lisboa, Lisboa, Portugal
- Institute of Molecular Medicine, Lisboa, Portugal
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Burnside K, Rajagopal L. Aspects of eukaryotic-like signaling in Gram-positive cocci: a focus on virulence. Future Microbiol 2011; 6:747-61. [PMID: 21797690 DOI: 10.2217/fmb.11.62] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Living organisms adapt to the dynamic external environment for their survival. Environmental adaptation in prokaryotes is thought to be primarily accomplished by signaling events mediated by two-component systems, consisting of histidine kinases and response regulators. However, eukaryotic-like serine/threonine kinases (STKs) have recently been described to regulate growth, antibiotic resistance and virulence of pathogenic bacteria. This article summarizes the role of STKs and their cognate phosphatases (STPs) in Gram-positive cocci that cause invasive infections in humans. Given that a large number of inhibitors to eukaryotic STKs are approved for use in humans, understanding how serine/threonine phosphorylation regulates virulence and antibiotic resistance will be beneficial for the development of novel therapeutic strategies against bacterial infections.
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Affiliation(s)
- Kellie Burnside
- Department of Pediatric Infectious Diseases, University of Washington & Seattle Children's Hospital Research Institute, 1900 Ninth Avenue, Seattle, WA 98101-1304, USA
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Chan TS, Wu MS, Suk FM, Chen CN, Chen YF, Hou YH, Lien GS. Enterococcus hirae-related acute pyelonephritis and cholangitis with bacteremia: an unusual infection in humans. Kaohsiung J Med Sci 2011; 28:111-4. [PMID: 22313539 DOI: 10.1016/j.kjms.2011.06.027] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Accepted: 01/31/2011] [Indexed: 10/17/2022] Open
Abstract
Very few reports are available from the literature related to Enterococcus hirae infection in humans, which is more frequently seen in animals and birds. We report two patients with E hirae bacteremia caused by acute pyelonephritis and acute cholangitis. The clinical courses have been smooth on use of sensitive antibiotic therapy. In both cases, the primary sources and portals of entry are clearly identified.
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Affiliation(s)
- Tze-Sian Chan
- Division of Gastroenterology, Department of Internal Medicine, Taipei Medical University, Wanfang Hospital, Taipei, Taiwan
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Abstract
An increasing proportion of Staphylococcus aureus infections are caused by methicillin-resistant S aureus. Treatment of infections caused by this organism is challenging, especially because therapy with vancomycin, the traditional antibiotic of choice for methicillin-resistant S aureus infections, is associated with an increasing frequency of treatment failure, and vancomycin insensitive and vancomycin-resistant strains have emerged. In addition, Enterococcus sp. isolated from human infections are increasingly resistant to multiple antimicrobial agents. Newer drugs available for treatment of resistant Gram-positive bacterial infections in the United States include linezolid, daptomycin, tigecycline and telavancin. The precise role for these newer agents is still evolving. Organisms resistant to each of these antimicrobials have emerged. New drugs in development include cephalosporins and carbapenems with MRSA activity.
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McBride SJ, Upton A, Roberts SA. Clinical characteristics and outcomes of patients with vancomycin-susceptible Enterococcus faecalis and Enterococcus faecium bacteraemia--a five-year retrospective review. Eur J Clin Microbiol Infect Dis 2009; 29:107-14. [PMID: 19916034 DOI: 10.1007/s10096-009-0830-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2009] [Accepted: 10/06/2009] [Indexed: 01/12/2023]
Abstract
The purpose of this study was to assess the epidemiology and outcomes of enterococcal bacteraemia. A retrospective review of demographic, microbiological and clinical data in patients 16 years of age and over with Enterococcus faecalis or E. faecium bacteraemia at Auckland City Hospital, New Zealand, from June 2002 to May 2007 was carried out. A total of 212 patients fulfilled the inclusion criteria, with 205 being included in the analysis. E. faecalis accounted for 86% (176/205) and E. faecium 14% (29/205) of the patients. Amoxycillin resistance occurred in 69% (20/29) of E. faecium isolates. High-level gentamicin resistance was present in 38% (65/171) of E. faecalis isolates and 25% (7/28) of E. faecium isolates (P = NS). No vancomycin-resistant enterococci were isolated. Healthcare association was present in 73% (149/205) of patients. Co-morbidities were present in 86% (176/205) of patients. The 7-day mortality was 13% (27/205) and the 30-day mortality 25% (52/205). On multivariate analysis, the 7-day mortality was statistically significantly associated with cirrhosis and shorter intravenous amoxycillin therapy. The 30-day mortality was statistically significantly associated with cirrhosis, malignancy, E. faecium bacteraemia and not receiving active antimicrobial therapy. No statistically significant association between high-level gentamicin resistance and mortality was demonstrated on multivariate analysis. Enterococcal bacteraemia occurs in a co-morbid, healthcare-exposed population. Associated mortality is high, and is associated with severe underlying disease, E. faecium bacteraemia and treatment factors.
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Affiliation(s)
- S J McBride
- Microbiology Department, John Radcliffe Hospital, Oxford, UK.
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Fisher K, Phillips C, McWatt L. The use of an antimicrobial citrus vapour to reduceEnterococcussp. on salad products. Int J Food Sci Technol 2009. [DOI: 10.1111/j.1365-2621.2009.01992.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Fernández-Rubio ME, Rebolledo-Lara L, Martinez-García M, Alarcón-Tomás M, Cortés-Valdés C. The conjunctival bacterial pattern of diabetics undergoing cataract surgery. Eye (Lond) 2009; 24:825-34. [PMID: 19713978 DOI: 10.1038/eye.2009.218] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To ascertain the conjunctival bacterial pattern of diabetics undergoing cataract operation to reduce the risk of postoperative endophthalmitis (PE). METHODS An observational retrospective study of the conjunctival bacteria of consecutive patients undergoing cataract surgery from July 2005 to November 2008. Records of patients having eye surgical prophylaxis in the 6 months before the culture and those patients having cataract operation combined with other surgical procedures were excluded. Aerobic and microaerobic cultures were carried out. Dade-Behring panels were used for bacterial identification. The database containing the isolated bacteria was linked to another Access database containing demographic and clinical data such as diabetes presence and baseline blood glucose and creatinine levels. The conjunctival bacteria of diabetics were compared with those of the non-diabetics. Epidat 3.1 program was used for statistical calculations. RESULTS From 5922 selected patients, 1325 (22.37%) knew they were diabetics (higher prevalence than expected). Among self-reported non-diabetics, 900 (15.2%) could be 'unknown' diabetics; another 274 had an impaired renal function; and 3423 non-diabetics joined the control group. Diabetics have a significantly higher prevalence of Staphylococcus aureus, Enterococci, certain Streptococci, and Klebsiella sp. than non-diabetics. Diabetics and non-diabetics having a blood creatinine level above 105.2 mumol/l had an increased conjunctival bacterial prevalence; these groups had a higher mean age and men predominated. CONCLUSIONS Diabetics have a conjunctival flora pattern whose increased bacteria are a predominant cause of many diabetic infections. An abnormally high blood creatinine level is an indicator of increased conjunctival colonisation in diabetics and non-diabetics.
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Affiliation(s)
- M E Fernández-Rubio
- Ophthalmic Institute Laboratory, Department of Ophthalmology, 'Gregorio Marañón' University General Hospital, Madrid, Spain.
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Fisher K, Phillips C. The ecology, epidemiology and virulence of Enterococcus. MICROBIOLOGY-SGM 2009; 155:1749-1757. [PMID: 19383684 DOI: 10.1099/mic.0.026385-0] [Citation(s) in RCA: 661] [Impact Index Per Article: 44.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Enterococci are Gram-positive, catalase-negative, non-spore-forming, facultative anaerobic bacteria, which usually inhabit the alimentary tract of humans in addition to being isolated from environmental and animal sources. They are able to survive a range of stresses and hostile environments, including those of extreme temperature (5-65 degrees C), pH (4.5-10.0) and high NaCl concentration, enabling them to colonize a wide range of niches. Virulence factors of enterococci include the extracellular protein Esp and aggregation substances (Agg), both of which aid in colonization of the host. The nosocomial pathogenicity of enterococci has emerged in recent years, as well as increasing resistance to glycopeptide antibiotics. Understanding the ecology, epidemiology and virulence of Enterococcus species is important for limiting urinary tract infections, hepatobiliary sepsis, endocarditis, surgical wound infection, bacteraemia and neonatal sepsis, and also stemming the further development of antibiotic resistance.
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Affiliation(s)
- Katie Fisher
- University of Northampton, School of Health, Park Campus, Boughton Green Road, Northampton NN2 7AL, UK
| | - Carol Phillips
- University of Northampton, School of Health, Park Campus, Boughton Green Road, Northampton NN2 7AL, UK
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Kuti EL, Patel AA, Coleman CI. Impact of inappropriate antibiotic therapy on mortality in patients with ventilator-associated pneumonia and blood stream infection: a meta-analysis. J Crit Care 2008; 23:91-100. [PMID: 18359426 DOI: 10.1016/j.jcrc.2007.08.007] [Citation(s) in RCA: 128] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2007] [Revised: 08/23/2007] [Accepted: 08/25/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Studies have found that initial treatment of ventilator-associated pneumonia (VAP) and blood stream infections (BSI) with inappropriate antimicrobial therapy is associated with higher rates of mortality, but additional studies have failed to confirm this. METHODS Databases were searched to identify studies that met the following criteria: observational trials, patients with VAP or BSI receiving appropriate and inappropriate antimicrobial therapy, and mortality data. We conducted random-effects model meta-analyses, both with and without adjustment. RESULTS Meta-analyses of VAP studies using unadjusted and adjusted data indicated that inappropriate therapy significantly increased patients' odds of mortality (odds ratio [OR], 2.34; 95% confidence interval [CI], 1.51-3.63; P = .0001, I 2 = 28.5% and OR, 3.03; 95% CI, 1.12-8.19; P = .0292, I 2 = 89.2%, respectively). Meta-analyses of BSI studies using unadjusted and adjusted data showed that inappropriate therapy significantly increased patients' odds of mortality (OR, 2.33; 95% CI, 1.96-2.76; P < .0001, I 2 = 48.7% and OR, 2.28; 95% CI, 1.43-3.65; P = .0006, I 2 = 88.2%, respectively). CONCLUSIONS There appears to be an association between initial inappropriate antimicrobial therapy and increased mortality in patients with VAP and BSI.
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Affiliation(s)
- Effie L Kuti
- University of Connecticut School of Pharmacy, Storrs, CT, USA
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