OBJECTIVE: This study was performed to determine prevalence and characterize the vancomycin-resistant and linezolid-resistant enterococcus isolates from a tertiary care center. Moreover, the antimicrobial susceptibility pattern of these isolates was also determined.
METHODS: A prospective study was performed in Medical College, Kolkata, India, over a period of two years (from January 2018 to December 2019). After obtaining clearance from the Institutional Ethics Committee, Enterococcus isolates from various samples were included in the present investigation. In addition to the various conventional biochemical tests, the VITEK 2 Compact system was used to identify the Enterococcus species. The isolates were tested for antimicrobial susceptibility to different antibiotics using the Kirby-Bauer disk diffusion method and VITEK 2 Compact to determine the minimum inhibitory concentration (MIC). The Clinical and Laboratory Standards Institute (CLSI) 2017 guidelines were used to interpret susceptibility. Multiplex PCR was performed for genetic characterization of the vancomycin-resistant Enterococcus isolates and sequencing was performed for characterization of the linezolid-resistant Enterococcus isolates.
RESULTS: During the period of two years, 371 isolates of Enterococcus spp. were obtained from 4934 clinical isolates showing a prevalence of 7.52%. Among these isolates, 239 (64.42%) were Enterococcus faecalis, 114 (30.72%) Enterococcus faecium, and others were Enterococcus durans, Enterococcus casseliflavus, Enterococcus gallinarum, and Enterococcus avium. Among these, 24 (6.47%) were VRE (Vancomycin-Resistant Enterococcus) of which 18 isolates were Van A type and six isolates of Enterococcus casseliflavus and Enterococcus gallinarum were resistant VanC type. There were two linezolid-resistant Enterococcus, and they were found to have the G2576T mutation. Among the 371 isolates, 252 (67.92%) were multi-drug resistant.
CONCLUSIONS: This study found an increasing prevalence of vancomycin-resistant Enterococcus isolates. There is also an alarming prevalence of multidrug resistance among these isolates.
目的:本研究旨在确定三级护理中心的万古霉素耐药和利奈唑胺肠球菌分离株的患病率和特征。此外,还确定了这些分离株的抗菌药物敏感性模式.
方法:在医学院进行了一项前瞻性研究,加尔各答,印度,为期两年(从2018年1月至2019年12月)。在获得机构伦理委员会的许可后,本研究包括来自各种样品的肠球菌分离株。除了各种常规的生化测试,VITEK2Compact系统用于鉴定肠球菌属。使用Kirby-Bauer圆盘扩散法和VITEK2Compact测定了分离株对不同抗生素的抗菌敏感性,以确定最低抑菌浓度(MIC)。临床和实验室标准研究所(CLSI)2017指南用于解释易感性。进行多重PCR以鉴定耐万古霉素的肠球菌分离株的遗传特征,并进行测序以鉴定耐利奈唑胺的肠球菌分离株。
结果:在两年期间,肠球菌属371株。从4934个临床分离株中获得,患病率为7.52%。在这些分离物中,239(64.42%)为粪肠球菌,114(30.72%)屎肠球菌,还有一些是durans肠球菌,卡里黄肠球菌,胆肠球菌,和禽肠球菌.其中,VRE(耐万古霉素肠球菌)24株(6.47%),其中18株为VanA型,6株为耐VanC型。有两种对利奈唑胺耐药的肠球菌,他们被发现有G2576T突变.在371个分离株中,多药耐药252例(67.92%)。
结论:本研究发现耐万古霉素肠球菌菌株的流行率增加。在这些分离株中,多药耐药性的流行率也令人震惊。