Antibiotic resistance of Enterococcus species: 3-year data

Yıl 2021, Cilt: 4 Sayı: 5, 670 - 674, 05.09.2021

Ali Korhan Sig , Tuğba Kula Atik , Alev Çetin Duran

https://doi.org/10.32322/jhsm.949498

Cited By: 2

Öz

Aim: The aim of this study is to investigate the prevalence of Enterococcus species and to evaluate susceptibilities to antimicrobial agents in a state (secondary) hospital.
Material and Methods: A total of 1676 enterococci strains (490 E.faecium, 1146 E.faecalis, 10 E.casseliflavus/E.gallinarum and 30 other Enterococcus species) isolated from cultures obtained from January 2017 to December 2019 in XXX Hospital were included. Blood cultures were incubated in automated device (Render Biotech Co.Ltd., PRC). Other cultures were incubated with conventional methods. Grown colonies were identified by PhoenixTM 100 automated system (Becton Dickinson, USA). Identifications that need confirmation or strains identified to genus level were further evaluated with conventional techniques. Antimicrobial susceptibility testing were performed by same system, Kirby-Bauer disc diffusion and gradient strip method according to EUCAST guidelines.
Results: 43.1%, 27.1%, 14.7% and 15.1% of enterococci were isolated from urine, blood/sterile body fluids, wound/abscess and other samples. Majority of the strains were ciprofloxacin (72.0%) and levofloxacin (74.1%) resistant, and more than 40% showed ampicillin and high-level gentamicin resistance. Glycopeptide resistance was relatively high (5.4%), especially when considering E.faecium (12.1%). There was not any tigecycline and linezolid resistance.
Conclusions: Antimicrobial resistance is a serious and growing public health problem affecting all countries, which is not just a topic of medicine, but multiple sectors such as commercial companies, food industry, veterinarians, etc. High percentages of resistance strongly indicate to get a local action, which should be followed by national and global one.

Anahtar Kelimeler

enterococci, vancomycin, antimicrobial stewardship, EUCAST, CLSI

Kaynakça

• Kilbas I, Ciftci IH. Antimicrobial resistance of Enterococcus isolates in Turkey: A meta-analysis of current studies. J Glob Antimicrob Res 2018; 12: 26-30.
• Calonico C, Pesavento G, Delfino V, Forni S, Nostro AL. Prevalence of Antibiotic Resistance in Enterococci: A 14 Year Survey. J Food Nutr Res 2018; 6: 626-37.
• Centers for Disease Control and Prevention (CDC). Antibiotic Resistance Threats in the United States, 2019. Atlanta, GA: U.S. Department of Health and Human Services, CDC; 2019. (doi: 10.15620/cdc:82532)
• Sieńko A, Czaban S, Ojdana D, et al. Comparison of antibiotic resistance and virulence in vancomycin-susceptible and vancomycin-resistant Enterococcus faecium strains. J Med Sci 2018; 87: 195-203.
• The European Committee on Antimicrobial Susceptibility Testing (EUCAST). Intrinsic resistance and unusual phenotypes version 3.2. Available at https://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Expert_Rules/2020/Intrinsic_Resistance_and_Unusual_Phenotypes_Tables_v3.2_20200225.pdf (Date of Access: 31 May 2020).
• Centers for Disease Control and Prevention (CDC). Bloodstream Infection Event (Central Line-Associated Bloodstream Infection and non-central line-associated Bloodstream Infection). Available at https://www.cdc.gov/nhsn/PDFs/pscManual/4PSC_CLABScurrent.pdf (Date of Access: 2 Feb 2020).
• The European Committee on Antimicrobial Susceptibility Testing (EUCAST). Breakpoint tables for interpretation of MICs and zone diameters version 11.0. Available at https://www.eucast.org/clinical_breakpoints/ (Date of Access: 16 December 2020).
• Ahmed MO, Baptiste KE. Vancomycin-resistant enterococci: a review of antimicrobial resistance mechanisms and perspectives of human and animal health. Microb Drug Resist 2018; 24: 590-606.
• Shridhar S, Dhanashree B. Antibiotic Susceptibility Pattern and Biofilm Formation in Clinical Isolates of Enterococcus spp. Interdiscip Perspect Infect Dis 2019. doi: 10.1155/2019/7854968.
• Miller WR, Murray BE, Rice LB, Arias CA. Vancomycin-Resistant Enterococci: Therapeutic Challenges in the 21st Century. Infect Dis Clin North Am 2016; 30: 35-9.
• Baldir G, Engin DO, Kucukercan M, et al. High-level resistance to aminoglycoside, vancomycin, and linezolid in Enterococci strains. J Microb Infect Dis 2013; 3: 100-3.
• Pourmand A, Mazer-Amirshahi M, Jasani G, May L. Emerging trends in antibiotic resistance: implications for emergency medicine. Am J Emerg Med 2017; 35: 1172-6.
• World Health Organization (WHO). Central Asian and European Surveillance of Antimicrobial Resistance (CAESAR), Annual 2019 Report, 2019. Available at https://www.euro.who.int/__data/assets/pdf_file/0003/418863/53373-WHO-CAESAR-annual-report-2019.pdf (Date of Access: 16 December 2020).
• https://www.who.int/news/item/27-02-2017-who-publishes-list-of-bacteria-for-which-new-antibiotics-are-urgently-needed (Date of Access: 16 December 2020).
• Mataj V, Guney M, Sig AK, et al. An Investigation into bacterial bloodstream infections and antibiotic resistance profiles in a tertiary hospital for a ten-year period. Clin Lab 2020; 66: 1467-77.
• Gandra S, Mojica N, Klein EY, et al. Trends in antibiotic resistance among major bacterial pathogens isolated from blood cultures tested at a large private laboratory network in India, 2008–2014. Int J Infect Dis 2016; 50: 75-82.
• https://hsgm.saglik.gov.tr/tr/uamdss (Date of Access: 16 December 2020).
• Cusack TP, Ashley EA, Ling CL, et al. Impact of CLSI and EUCAST breakpoint discrepancies on reporting of antimicrobial susceptibility and AMR surveillance. Clin Microb Infect 2019; 25: 910-1.
• Versporten A, Bolokhovets G, Ghazaryan L, et al. Antibiotic use in Eastern Europe: a cross-national database study in coordination with the WHO Regional Office for Europe. Lancet Infect Dis 2014; 14: 381-7.
• CLSI. Performance Standards for Antimicrobial Susceptibility Testing; CLSI document M100-30th Edition. Weinstein, MP: Clinical and Laboratory Standards Institute; 2020.
• https://www.tmc-online.org/userfiles/file/26-37.pdf (Date of Access: 16 December 2020).
• Isler B, Keske Ş, Aksoy M, et al. Antibiotic overconsumption and resistance in Turkey. Clin Microb Infect 2019; 25: 651-3.