Objectives:To find the prevalence of uropathogenic Escherichia coli (E. coli)-producing extended spectrum beta lactamase (ESBL) at King Fahd Military Medical Complex in Dhahran (KFMMC) and to detect the genes responsible for its production. In addition, we determined the pattern of multi-drug resistance among isolates.Methods:A total of 117 uropathogenic E. coli isolates were collected from KFMMC over a period of 4 months from March 2014 to June 2014. These were received in the Microbiology Laboratory at Prince Sultan Military College of Health Sciences (PSMCHS), Dhahran, Saudi Arabia for analysis. The isolates were screened for ESBL using VITEK® 2 Compact. Polymerase chain reaction (PCR) examination was used to determine TEM, SHV, and CTX-M genes.Results:Our findings indicated that there is a high incidence of ESBLs among the E. coli isolated from UTI (23.1%). Our study also indicated that CTX-M genes are the most prevalent among the isolates at KFMMC followed by TEM class (6%), but there was also a higher percentage E. coli (3.4%) simultaneously harboring TEM and CTX-M genes. None of our isolates harbored the SHV genes.Conclusion:The findings document the threat of ESBL among E. coli isolates from UTI especially the CTX-M class in our hospital with the occurrence of these strains as etiologic agents of infection in the hospital and community.

Vancomycin-resistant enterococci (VRE) poses a formidable challenge to public health due to its inherent resistance to multiple antibiotics coupled with the ability to transfer genetic determinants to dangerous pathogens like Methicillin-resistant Staphylococcus aureus (MRSA). The purpose of this study was to investigate the incidence of vancomycin resistance in enterococci among clinical isolates at a tertiary care military hospital in the eastern region of Saudi Arabia and to detect van genes using multiplex-PCR. Overall, 246 isolates of enterococci were collected from various clinical specimens. The isolates were identified, and antimicrobial susceptibility testing was done using the Vitek 2 system. Multiplex PCR was performed on the VRE isolates, thus identified to determine the van genes harbored. A total of 15 VRE were identified, of which 14 (93.3%) were Enterococcus faecium , and 1(6.7%) was Enterococcus casseliflavus with intrinsic vanC resistance. Of the 14 vancomycin-resistant Enterococcus faecium , 8 (57.1%) harbored vanB genes, while 6 (42.8%) harbored vanA genes. All the VRE were susceptible to linezolid and tigecycline. Our study detected a low prevalence (6.1%) of VRE among clinical isolates of enterococci and that the vanB gene predominates in such strains. Susceptibility profiles indicated that linezolid and tigecycline are still effective against these multidrug-resistant pathogens. Pus specimens yielded the highest percentage (53.3%) of isolates from which VRE was obtained, and this finding is novel among studies done in Saudi Arabia.

Background: The pathogenic potential of enterococci to produce life-threatening infections is well-documented. The scientific community has, of late, evinced a renewed interest in the putative virulence factors of enterococci. Objective of the study was to determine the putative virulence factors of clinically isolated Enterococcus species from a military hospital and to describe the association between virulence factors and vancomycin susceptibility.Methods: A total of 245 enterococci were isolated from clinical samples collected from KFMMC, a leading military hospital in the eastern province of Saudi Arabia. Following species identification and antimicrobial susceptibility testing using the Vitek 2 system; the isolates were tested for the production of caseinase, gelatinase, biofilm, and presence of haemolysin.Results: Among the enterococcal isolates, 36.7% produced caseinase, 38% produced gelatinase, 24.1% exhibited biofilm formation, and 30.6% were positive for haemolytic activity. A significant association between vancomycin susceptibility patterns and the virulence factors, gelatinase and haemolytic activity, were noted. No significant associations were observed between vancomycin susceptibility patterns and the presence of caseinase or the formation of biofilms.Conclusions: Virulence factors are invariably produced by several clinical isolates of enterococci in our hospital, and some virulence factors are associated with vancomycin susceptibility.