Prevalence of aac (6′)-Ie-aph (2″)-Ia gene and drug resistance pattern of Enterococcus isolated in a tertiary care hospital

Authors

  • Ayan K. Das Department of Microbiology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi
  • Shyamasree Nandy Department of Microbiology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi
  • Mridu Dudeja Department of Microbiology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20151041

Keywords:

Enterococci, HLGR, VRE

Abstract

Background: Enterococci causes serious infection due to its higher ability to colonize and increasing resistance to various drugs. Mutation and plasmid mediated genetic exchange are the main reason for the high rate of acquisition of antibiotic resistance. The study was aimed to determine the antibiotic resistance profile of the enterococcal isolates from various clinical samples and to detect the presence of aac (6′) Ie-aph (2″) Ia gene in the isolates which show phenotypic high level gentamicin resistance.

Methods:Clinical enterococcal isolates from a tertiary care hospital in southern Delhi were subjected to antibiotic susceptibility testing.  MIC for High level gentamicin was measured and the isolates were tested for presence of aac (6′) Ie-aph (2″) Ia gene by PCR.

Results: Out of the total 146 Enterococcal isolates, 112 were E. fecalis, 33 were E faecium and 1 was E gallinarum. 26.02% were resistant to High level gentamicin, and 15% were resistant to streptomycin. Vancomycin resistance was 5.4%. 11 E. fecalis and 25 E. faecium isolates showed presence of aac (6′) Ie-aph (2″) Ia gene.

Conclusions:High level antibiotic resistance among enterococci and the spread of vancomycin resistant is an issue of serious concern. Isolation rate of E. fecalis was much higher than E. faecium, but aac (6′) Ie-aph (2″) Ia gene was more prevalent in E.faecium. The study highlights spread of the gene aac (6′)-Ie-aph (2″)-Ia among the enterococcal isolates which can be easily transferred to other pathogenic gram positive cocci.

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References

Witte W, Wirth R, Klare I. Enterococci. Chemotherapy 1999; 45(2):135-45.

Pallares R, Pujol M, Pena C, Ariza J, Martin R, Gudiol F. Cephalosporins as risk factor for nosocomial Enterococcus faecalis bacteremia. A matched case–control study. Arch Intern Med 1993; 153(13):1581-6.

Gray JW, Pedler SJ. Antibiotic-resistant enterococci. J Hosp Infect 1992;21:1-14.

Murray BE. Beta-lactamase-producing enterococci. Antimicrob Agents Chemother 1992;36:2355-59.

Moellering RC Jr, Weinberg AN. Studies on antibiotic syngerism against enterococci. Effect of various antibiotics on the uptake of 14 C-labeled streptomycin by enterococci. J Clin Invest,1971;50:2580-84.

Murray BE. Vancomycin resistant Enterococci. American J Med 1997;101:284-93.

Simjee S and Gill MJ. Gene transfer, gentamicin resistance and enterococci. J Hosp Infect 1997;36: 249-59.

Feizabadi MM, Maleknejad P, Asgharzadeh A, Asadi S, Shokrzadeh L, Sayadi S. Prevalence of aminoglycoside-modifying enzymes genes among isolates of Enterococcus faecalis and Enterococcus faecium in Iran. Microb Drug Resis 2006;12:265-68.

Koneman EW, Allen SD, Janda WM & Schreckenberger PC. The Gram positive cocci I. Staphylococci and related organisms. In: Koneman EW, Allen SD, Janda WM, Schreckenberger PC, Propcop GW, Woods G L & Winn WC Jr eds. Color Atlas and Textbook of Diagnostic Microbiology. Philadelphia, Lippincott–Raven; 2006:624–662.

Clinical Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. Seventeenth Informational Supplement. CLSI document (M100-S22) Vol31, No1, Clinical and Laboratory Standard Institute: Wayne, Pennsylvania.2012.

Perez-Hernandez X, Mendez-Alvarez S, Delgado T, Moreno A, Reyes-Darias J A, Lopez A S et al. Low prevalence of vancomycin-resistant enterococci in clinical samples from hospitalized patients of the Canary Islands, Spain. Int Microbiol 2002;5:117–120.

Vakulenko SB, Donabedian SM, Voskresenskiy AM, Voskresenskiy AM, Zervos MJ, Lerner SA, et al. Multiplex PCR for detection of aminoglycoside resistance genes in enterococci. Antimicrob Agents Chemother 2003;47:1423-26.

Low DE, Keller N, Barth A, Jones RN. Clinical prevalence, antimicrobial susceptibility, and geographic resistance patterns of enterococci: results from the SENTRY Antimicrobial Surveillance Program, 1997-1999. Clin Infect Dis 2001;32:133-45.

Sood S, Malhotra M, Das B K, Kapil A. Enterococcal infections & antimicrobial resistance. Indian J Med Res 2008Aug; 128:111-121.

Oberoi L and Aggarwal A. Multidrug Resistant Enterococci in a Rural Tertiary Care Hospital- A Cause of Concern. J k science 2010;12(3):157-8.

Mendiratta DK, Kaur H, Deotale V, Thamke DC, Narang R, Narang P. Status of high level aminoglycoside resistant Enterococcus faecium and Enterococcus faecalis in a rural hospital of central India. Indian J Med Microbiol. 2008Oct-Dec; 26(4):369-71.

Gupta V, Singla N. Speciation and Antimicrobial Susceptibility pattern of Enterococci from a Tertiary Health Care Center of North India. J Clin Diag Research. 2007Oct; 1(5):385-389.

Karmarkar MG, Gershom ES, Mehta PR. Enterococcal infections with special reference to phenotypic characterization &drug resistance. Indian J Med Res 2004;119(Suppl):22–5.

Mathur P, Kapil A, Chandra R, Sharma P, Das B. Antimicrobial resistance in Enterococcus faecalis at a tertiary care centre of northern India. Indian J Med Res 2003July; 118:25-28.

Salem - Bekhit MM, Moussa I, Muharram MM, Alanazy FK, Hefni HM. Prevalence and antimicrobial resistance pattern of multidrug-resistant enterococci isolated from clinical specimens. Indian J Med Microbiol 2012;30:44- 51.

Telkar A, Baragundi MC, Raghavendra VP, Vishwanath G, Chandrappa NR. Change in the Prevalence and the Antibiotic Resistance of the Enterococcal Species Isolated from Blood Cultures. JCDR 2012; 6(3 ):405 – 408.

Padmasini E, Padmaraj R, Ramesh RR. Detection of vancomycin resistant Enterococci with vanA genotype in clinical isolates from a tertiary care center. Indian J Med Microbiol 2014;32(1):89–101.

DeLisle S, Perl TM. Vancomycin-resistant enterococci: a road map on how to prevent the emergence and transmission of antimicrobial resistance. Chest. 2003May;123(5 Suppl):504-18.

Mohanty S, Jose S, Singhal R, Sood S, Dhawan B, Das BK, et al. Species prevalence and antimicrobial susceptibility of enterococci isolated in a tertiary care hospital of north India. Southeast Asian J Trop Med Public Health 2005;36 :962-5.

Kapoor L, Randhawa VS, Deb M. Antimicrobial resistance of enterococcal blood isolates at a pediatric care hospital in India. Jpn J Infect Dis. 2005;58:101-3

Chow J W. Aminoglycoside resistance in enterococci. Clin Infect Dis 2000;31:586-589.

Bodnar UR, Noskin GA, Suriano T, Cooper I, Reisberg BE, Peterson LR. Use of in-house studies of molecular epidemology and full species identification for controlling spread of vancomycin-resistant Enterococcus faecalis isolates. J Clin Microbiol 1996;34:2129–2132.

Sujatha S and Praharaj I. Glycopeptide Resistance in Gram-Positive Cocci: A Review. Inter disciplinary Perspectives on Infectious Diseases 2012;2012:1-10.

Vithiya G, Harish BN, Parija SC. Vancomycin Resistant Enterococcus Causing Bloodstream Infection. I J Fundamental and Applied Life Sciences 2011;1 (2):194-196.

Taneja N, Rani P, Emmanuel R & Sharma M. Significance of vancomycin resistant Enterococci from urinary specimens at a tertiary care centre in northern India. Indian J Med Res 2004;119:72-74.

Hodel-Christian SL, Murray BE. Characterization of the gentamicin resistance transposon Tn5281 from Enterococcus faecalis and comparison to staphylococcal transposons Tn4001 and Tn4031. Antimicrob Agents Chemother. 1991;35(6):1147–52.

Hasani A, Sharifi Y, Ghotaslou R, Naghili B, Hasani A, Aghazadeh M, Milani M, Mazmani A. Molecular screening of virulence genes in high-level gentamicin-resistant Enterococcus faecalis and Enterococcus faecium isolated from clinical specimens in Northwest Iran. Indian J Med Microbiol. 2012;30:175–181.

Tsai SF, Zervos MJ, Clewell DB, Donabedian SM, Sahm DF, Chow JW. A new high-level gentamicin resistance gene,aph(2)-Id, in Enterococcus spp. Antimicrob Agents Chemother. 1998;42:1229–32.

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Published

2017-02-06

How to Cite

Das, A. K., Nandy, S., & Dudeja, M. (2017). Prevalence of aac (6′)-Ie-aph (2″)-Ia gene and drug resistance pattern of Enterococcus isolated in a tertiary care hospital. International Journal Of Community Medicine And Public Health, 2(4), 520–525. https://doi.org/10.18203/2394-6040.ijcmph20151041

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Original Research Articles