1
|
Amaro P, Ferreira J, Viegas R, Cardoso A, Correia J, Maurício H. Multifocal joint infection caused by Enterococcus gallinarum. Mod Rheumatol Case Rep 2020; 5:384-386. [PMID: 33153412 DOI: 10.1080/24725625.2020.1847429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Musculoskeletal infections caused by Enterococcus gallinarum are rare, but due to its multi-drug resistance has gained more and more attention from the scientific community. We report a case of a 81-year-old immunocompetent Caucasian female with a multifocal joint infection caused by this agent. Shoulder arthrocentesis and two different blood cultures were used to identify this vancomycin-resistant agent in a symptomatic patient. After surgical debridement and 8 weeks of antibiotherapy with ampicillin (1000 mg IV every 6 h), the clinical and laboratory findings were all remarkably improved after treatment. After 2 years follow-up, the patient had no recurrence.
Collapse
Affiliation(s)
| | | | - Rui Viegas
- Hospital Beatriz Ângelo, Loures, Portugal
| | | | | | | |
Collapse
|
2
|
Oravcova V, Mihalcin M, Zakova J, Pospisilova L, Masarikova M, Literak I. Vancomycin-resistant enterococci with vanA gene in treated municipal wastewater and their association with human hospital strains. Sci Total Environ 2017; 609:633-643. [PMID: 28763660 DOI: 10.1016/j.scitotenv.2017.07.121] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 07/10/2017] [Accepted: 07/13/2017] [Indexed: 05/22/2023]
Abstract
Vancomycin-resistant enterococci (VRE) are pathogens of increasing medical importance. In Brno, Czech Republic, we collected 37 samples from the effluent of a wastewater treatment plant (WWTP), 21 surface swabs from hospital settings, and 59 fecal samples from hospitalized patients and staff. Moreover, we collected 284 gull cloacal swabs from the colony situated 35km downstream the WWTP. Samples were cultured selectively. Enterococci were identified using MALDI-TOF MS, phenotypically tested for susceptibility to antibiotics, and by PCR for occurrence of resistance and virulence genes. Pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST) were used to examine genotypic diversity. VRE carrying the vanA gene were found in 32 (86%, n=37) wastewater samples, from which we obtained 49 isolates: Enterococcus faecium (44) and Enterococcus gallinarum (2), Enterococcus casseliflavus (2), and Enterococcus raffinosus (1). From 33 (69%) of 48 inpatient stool samples, we obtained 39 vanA-carrying VRE, which belonged to E. faecium (33 isolates), Enterococcus faecalis (4), and Enterococcus raffinosus (2). Nearly one-third of the samples from hospital surfaces contained VRE with the vanA gene. VRE were not detected among gulls. Sixty-seven (84%, n=80) E. faecium isolates carried virulence genes hyl and/or esp. Virulence of E. faecalis was encoded by gelE, asa1, and cylA genes. A majority of the E. faecium isolates belonged to the clinically important sequence types ST17 (WWTP: 10 isolates; hospital: 4 isolates), ST18 (9;8), and ST78 (5;0). The remaining isolates belonged to ST555 (2;0), ST262 (1;6), ST273 (3;0), ST275 (1;0), ST549 (2;0), ST19 (0;1), ST323 (3;0), and ST884 (7;17). Clinically important enterococci carrying the vanA gene were almost continually detectable in the effluent of the WWTP, indicating insufficient removal of VRE during wastewater treatment and permanent shedding of these antibiotic resistant pathogens into the environment from this source. This represents a risk of their transmission to the environment.
Collapse
Affiliation(s)
- Veronika Oravcova
- Department of Biology and Wildlife Diseases, Faculty of Veterinary Hygiene and Ecology, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic; CEITEC VFU, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic.
| | - Matus Mihalcin
- Department of Infectious Diseases, University Hospital Brno, Brno, Czech Republic; Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jana Zakova
- Department of Biology and Wildlife Diseases, Faculty of Veterinary Hygiene and Ecology, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic
| | - Lucie Pospisilova
- Department of Biology and Wildlife Diseases, Faculty of Veterinary Hygiene and Ecology, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic
| | - Martina Masarikova
- CEITEC VFU, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic; Department of Infectious Diseases and Microbiology, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic
| | - Ivan Literak
- Department of Biology and Wildlife Diseases, Faculty of Veterinary Hygiene and Ecology, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic; CEITEC VFU, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic
| |
Collapse
|
3
|
Ahmed MO, Baptiste KE. Vancomycin-Resistant Enterococci: A Review of Antimicrobial Resistance Mechanisms and Perspectives of Human and Animal Health. Microb Drug Resist 2017; 24:590-606. [PMID: 29058560 DOI: 10.1089/mdr.2017.0147] [Citation(s) in RCA: 209] [Impact Index Per Article: 29.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Vancomycin-resistant enterococci (VRE) are both of medical and public health importance associated with serious multidrug-resistant infections and persistent colonization. Enterococci are opportunistic environmental inhabitants with a remarkable adaptive capacity to evolve and transmit antimicrobial-resistant determinants. The VRE gene operons show distinct genetic variability and apparently continued evolution leading to a variety of antimicrobial resistance phenotypes and various environmental and livestock reservoirs for the most common van genes. Such complex diversity renders a number of important therapeutic options including "last resort antibiotics" ineffective and poses a particular challenge for clinical management. Enterococci resistance to glycopeptides and multidrug resistance warrants attention and continuous monitoring.
Collapse
Affiliation(s)
- Mohamed O Ahmed
- 1 Department of Microbiology and Parasitology, Faculty of Veterinary Medicine, University of Tripoli , Tripoli, Libya
| | - Keith E Baptiste
- 2 Department of Veterinary Medicine, Danish Medicines Agency , Copenhagen South, Denmark
| |
Collapse
|
4
|
de Mello SS, Van Tyne D, Dabul AN, Gilmore MS, Camargo IL. High-Quality Draft Genome Sequence of the Multidrug-Resistant Clinical Isolate Enterococcus faecium VRE16. Genome Announc 2016; 4:e00992-16. [PMID: 27660781 DOI: 10.1128/genomeA.00992-16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Specific lineages of the commensal bacterium Enterococcus faecium belonging to CC17, especially ST412, have been isolated from patients in several hospitals worldwide and harbor antibiotic resistance genes and virulence factors. Here, we report a high-quality draft genome sequence and highlight features of E. faecium VRE16, a representative of this ST.
Collapse
|
5
|
Jo I, Song CE, Park KG, Park YJ. Comparison of Three Chromogenic Media for Recovery of Vancomycin-Resistant Enterococci from Rectal Swab Samples. Ann Clin Microbiol 2015. [DOI: 10.5145/acm.2015.18.3.82] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Irene Jo
- Department of Laboratory Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Chang Eun Song
- Department of Laboratory Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Kang Gyun Park
- Department of Laboratory Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Yeon-Joon Park
- Department of Laboratory Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea
| |
Collapse
|
6
|
Batistão DWDF, Gontijo-Filho PP, Conceição N, Oliveira AGD, Ribas RM. Risk factors for vancomycin-resistant enterococci colonisation in critically ill patients. Mem Inst Oswaldo Cruz 2012; 107:57-63. [PMID: 22310536 DOI: 10.1590/s0074-02762012000100008] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2011] [Accepted: 10/10/2011] [Indexed: 11/21/2022] Open
Abstract
Vancomycin-resistant enterococci (VRE) are important hospital pathogens and have become increasingly common in patients admitted to the intensive care unit (ICU). To determine the incidence and the risk factors associated with VRE colonisation among ICU patients, active surveillance cultures for VRE faecal carriages were carried out in patients admitted to the ICU of the University Hospital of Uberlândia, Minas Gerais, Brazil. Risk factors were assessed using a case-control study. Seventy-seven patients (23.1%) were found to be colonised with vanC VRE and only one patient (0.3%) was colonised with vanA VRE. Independent risk factors for VRE colonisation included nephropathy [odds ratio (OR) = 13.6, p < 0.001], prior antibiotic use (OR = 5.5, p < 0.03) and carbapenem use (OR = 17.3, p < 0.001). Our results showed a higher frequency (23.1%) of Enterococcus gallinarum and Enterococcus casseliflavus, species that are intrinsically resistant to low levels of vancomycin (vanC), without an associated infection, associated with prior antibiotic use, carbapenem use and nephropathy as comorbidity. This study is the first to demonstrate the risk factors associated with vanC VRE colonisation in ICU hospitalised patients. Although vanA and vanB enterococci are of great importance, the epidemiology of vanC VRE needs to be better understood. Even though the clinical relevance of vanC VRE is uncertain, these species are opportunistic pathogens and vanC VRE-colonised patients are a potential epidemiologic reservoir of resistance genes.
Collapse
|
7
|
Getachew Y, Hassan L, Zakaria Z, Zaid CZM, Yardi A, Shukor RA, Marawin LT, Embong F, Aziz SA. Characterization and risk factors of vancomycin-resistant Enterococci (VRE) among animal-affiliated workers in Malaysia. J Appl Microbiol 2012; 113:1184-95. [PMID: 22906187 DOI: 10.1111/j.1365-2672.2012.05406.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Revised: 07/15/2012] [Accepted: 07/16/2012] [Indexed: 11/28/2022]
Abstract
AIMS This study determined the risk factors and characteristics of vancomycin-resistant Enterococci (VRE) among individuals working with animals in Malaysia. METHODS AND RESULTS Targeted cross-sectional studies accompanied with laboratory analysis for the identification and characterization of resistance and virulence genes and with genotype of VRE were performed. VRE were detected in 9·4% (95% CI: 6·46-13·12) of the sampled populations. Enterococcus faecium, Enterococcus faecalis and Enterococcus gallinarum were isolated, and vanA was detected in 70% of the isolates. Enterococcus faecalis with vanB was obtained from one foreign poultry worker. At least one virulence gene was detected in >50% of Ent. faecium and Ent. faecalis isolates. The esp and gelE genes were common among Ent. faecium (58·3%) and Ent. faecalis (78%), respectively. The VRE species showed diverse RAPD profiles with some clustering of strains based on the individual's background. However, the risk factors found to be significantly associated with the prevalence of VRE were age (OR: 5·39, 95% CI: 1·98-14·61) and previous hospitalization (OR: 4·06, 95% CI: 1·33-12·35). CONCLUSION VRE species isolated from individuals in this study have high level of vancomycin resistance, were genetically diverse and possessed the virulence traits. Age of individuals and history of hospitalization rather than occupational background determined VRE colonization. SIGNIFICANCE AND IMPACT OF THE STUDY This study provides comprehensive findings on the epidemiological and molecular features of VRE among healthy individuals working with animals.
Collapse
Affiliation(s)
- Y Getachew
- Department of Veterinary Pathology and Microbiology, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Cantarelli V, Cavalcante B, Pilger DA, Souza F, Dias CG, Brodt T, Cantarelli M, Secchi C, d'Azevedo PA. Rapid detection of Van genes in rectal swabs by real time PCR in Southern Brazil. Rev Soc Bras Med Trop 2011; 44:631-2. [PMID: 22031081 DOI: 10.1590/s0037-86822011000500021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Accepted: 11/30/2010] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Laboratory-based surveillance is an important component in the control of vancomycin resistant enterococci (VRE). METHODS The study aimed to evaluate real-time polymerase chain reaction (RT-PCR) (genes vanA-vanB) for VRE detection on 115 swabs from patients included in a surveillance program. RESULTS Sensitivity of RT-PCR was similar to primary culture (75% and 79.5%, respectively) when compared to broth enriched culture, whereas specificity was 83.1%. CONCLUSIONS RT-PCR provides same day results, however it showed low sensitivity for VRE detection.
Collapse
|
9
|
Haenni M, Saras E, Châtre P, Meunier D, Martin S, Lepage G, Ménard MF, Lebreton P, Rambaud T, Madec JY. vanAinEnterococcus faecium, Enterococcus faecalis, andEnterococcus casseliflavusDetected in French Cattle. Foodborne Pathog Dis 2009; 6:1107-11. [DOI: 10.1089/fpd.2009.0303] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Marisa Haenni
- Agence Française de Sécurité Sanitaire des Aliments (AFSSA), Unité Bactériologie Bovine et Hygiène des Viandes, Lyon, France
| | - Estelle Saras
- Agence Française de Sécurité Sanitaire des Aliments (AFSSA), Unité Bactériologie Bovine et Hygiène des Viandes, Lyon, France
| | - Pierre Châtre
- Agence Française de Sécurité Sanitaire des Aliments (AFSSA), Unité Bactériologie Bovine et Hygiène des Viandes, Lyon, France
| | - Danièle Meunier
- Agence Française de Sécurité Sanitaire des Aliments (AFSSA), Unité Bactériologie Bovine et Hygiène des Viandes, Lyon, France
| | | | | | | | | | | | - Jean-Yves Madec
- Agence Française de Sécurité Sanitaire des Aliments (AFSSA), Unité Bactériologie Bovine et Hygiène des Viandes, Lyon, France
| |
Collapse
|
10
|
Sahlström L, Rehbinder V, Albihn A, Aspan A, Bengtsson B. Vancomycin resistant enterococci (VRE) in Swedish sewage sludge. Acta Vet Scand 2009; 51:24. [PMID: 19480649 PMCID: PMC2693504 DOI: 10.1186/1751-0147-51-24] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2008] [Accepted: 05/29/2009] [Indexed: 11/30/2022] Open
Abstract
Background Antimicrobial resistance is a serious threat in veterinary medicine and human healthcare. Resistance genes can spread from animals, through the food-chain, and back to humans. Sewage sludge may act as the link back from humans to animals. The main aims of this study were to investigate the occurrence of vancomycin resistant enterococci (VRE) in treated sewage sludge, in a Swedish waste water treatment plant (WWTP), and to compare VRE isolates from sewage sludge with isolates from humans and chickens. Methods During a four month long study, sewage sludge was collected weekly and cultured for VRE. The VRE isolates from sewage sludge were analysed and compared to each other and to human and chicken VRE isolates by biochemical typing (PhenePlate), PFGE and antibiograms. Results Biochemical typing (PhenePlate-FS) and pulsed field gel electrophoresis (PFGE) revealed prevalence of specific VRE strains in sewage sludge for up to 16 weeks. No connection was found between the VRE strains isolated from sludge, chickens and humans, indicating that human VRE did not originate from Swedish chicken. Conclusion This study demonstrated widespread occurrence of VRE in sewage sludge in the studied WWTP. This implies a risk of antimicrobial resistance being spread to new farms and to the society via the environment if the sewage sludge is used on arable land.
Collapse
|
11
|
Neves FP, Ribeiro RL, Duarte RS, Teixeira LM, Merquior VL. Emergence of the vanA genotype among Enterococcus gallinarum isolates colonising the intestinal tract of patients in a university hospital in Rio de Janeiro, Brazil. Int J Antimicrob Agents 2009; 33:211-5. [DOI: 10.1016/j.ijantimicag.2008.08.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2008] [Revised: 08/11/2008] [Accepted: 08/11/2008] [Indexed: 11/24/2022]
|
12
|
Merquior VLC, Gonçalves Neves FP, Ribeiro RL, Duarte RS, de Andrade Marques E, Teixeira LM. Bacteraemia associated with a vancomycin-resistant Enterococcus gallinarum strain harbouring both the vanA and vanC1 genes. J Med Microbiol 2008; 57:244-245. [DOI: 10.1099/jmm.0.47429-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A case of a post-surgical patient who developed a fatal bloodstream infection caused by high-level vancomycin-resistant Enterococcus gallinarum is reported. The isolate was found to carry both the vanC1 and vanA genes. This is the first report of an invasive infection associated with a vanA E. gallinarum isolate in Brazil.
Collapse
Affiliation(s)
| | - Felipe Piedade Gonçalves Neves
- Instituto de Microbiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Rachel Leite Ribeiro
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Rafael Silva Duarte
- Instituto de Microbiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Lúcia Martins Teixeira
- Instituto de Microbiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| |
Collapse
|
13
|
Affiliation(s)
| | | | - Antonella Costa
- Istituto Zooprofilattico Sperimentale della Sicilia, Palermo, Italy
| | | |
Collapse
|
14
|
Maschieto A, Martinez R, Palazzo ICV, Darini ALDC. Antimicrobial resistance of Enterococcus sp. isolated from the intestinal tract of patients from a university hospital in Brazil. Mem Inst Oswaldo Cruz 2004; 99:763-7. [PMID: 15654436 DOI: 10.1590/s0074-02762004000700018] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
This study reports the results about antimicrobial resistance of Enterococcus spp. isolated from intestinal tract of patients from a university hospital in Brazil. The identification of strains at species level was performed by conventional biochemical tests, API 20 Strep (bioMérieux), and polymerase chain reaction assay. The species distribution was E. faecium (34%), followed by E. faecalis (33%), E. gallinarum (23.7%), E. casseliflavus (5.2%), E. avium (1%), and E. hirae (1%). Intrinsic resistance to vancomycin characterized by presence of vanC genes was found in E. gallinarum and E. casseliflavus. The high prevalence of VanC phenotype enterococci is very important because these species have been reported as causing a wide variety of infections. Vancomycin-resistant E. faecium or E. faecalis were not found and no one isolate of these species was a beta-lactamase producer. Thirteen clinical isolates of enterococci (13.4%) showed multiresistance patterns, which were defined by resistance to three classes of antibiotics plus resistance to at least one aminoglycoside (gentamicin and/or streptomycin). The resistance to several antimicrobials shown by enterococcal strains obtained in this study is of concern because of the decrease in the therapeutic options for treatment of infections caused by enterococci.
Collapse
Affiliation(s)
- Andresa Maschieto
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas, USP, 14040-903 Ribeirão Preto, SP, Brazil
| | | | | | | |
Collapse
|