Increasing Prevalence of Aminoglycoside-Resistant Enterococcus faecalis Isolates Due to the aac(6’)-aph(2”) Gene: A Therapeutic Problem in Kermanshah, Iran

Khani, Mitra; Fatollahzade, Mahdie; Pajavand, Hamid; Bakhtiari, Somaye; Abiri, Ramin

doi:10.5812/jjm.28923

Cited by 17 publications

(14 citation statements)

References 24 publications

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“…In this study, the most prevalent aminoglycoside resistance gene among the HLGR isolates was aph(3′)-IIIa (92.6%), and the aac(6′)-Ie-aph(2′′)-Ia gene was found in 62.9% of them (Table II). It was contrary to previous studies that the aac (6′)-Ie-aph(2′′)-Ia gene has been characterized as the main aminoglycoside [30][31][32]. In a study conducted in Tehran, north of Iran, the aac(6′)-Ie-aph(2′′)-Ia and ant(4′)-Ia genes were detected in HLGR enterococci [30].…”

Section: Discussionmentioning

confidence: 80%

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High prevalence of vancomycin and high-level gentamicin resistance in Enterococcus faecalis isolates

Taji

Heidari

Ebrahim‐Saraie

et al. 2018

AMicr

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Multiple drug-resistant enterococci are major cause of healthcare-associated infections due to their antibiotic resistance traits. Among them, Enterococcus faecalis is an important opportunistic pathogen causing various hospital-acquired infections. A total of 53 E. faecalis isolates were obtained from various infections. They were identified by phenotypic and genotypic methods. Determination of antimicrobial resistance patterns was done according to CLSI guidelines. The isolates that were non-susceptible to at least one agent in ≥3 antimicrobial categories were defined as multidrug-resistant (MDR). Detection of antimicrobial resistance genes was performed using standard procedures. According to MDR definition, all of the isolates were MDR (100%). High-level gentamicin resistance was observed among 50.9% of them (MIC ≥ 500 μg/ml). The distributions of aac(6′)-Ie-aph(2′′)-Ia and aph(3′)-IIIa genes were 47.2% and 69.8%, respectively. The aph(2′′)-Ib, aph(2′′)-Ic, aph(2′′)-Id, and ant(4′)-Ia genes were not detected. Vancomycin resistance was found in 45.3% of strains. The vanA gene was detected in 37.7% of isolates, whereas vanB and vanC 1 genes were not observed in any strain. Erythromycin resistance rate was 79.2% and the frequencies of ermB and ermC genes were 88.6% and 69.8%, respectively. The ermA and msrA genes were not present in any of the isolates. Our data indicate a high rate of MDR E. faecalis strains. All of high-level gentamicin-resistant isolates carried at least one of aac(6′)-Ie-aph(2′′)-Ia or aph(3′)-IIIa genes. Distribution of vanA was notable among the isolates. In addition, ermB and ermC were accountable for resistance to erythromycin.

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Section: Discussionmentioning

confidence: 80%

“…Our results indicated that 50.9% of isolates were HLGR (MIC ≥ 500 μg/ml). In the several studies, high-level gentamicin resistance among E. faecalis isolates was reported in 65%-96% of the strains [29][30][31].…”

Section: Discussionmentioning

confidence: 99%

High prevalence of vancomycin and high-level gentamicin resistance in Enterococcus faecalis isolates

Taji

Heidari

Ebrahim‐Saraie

et al. 2018

AMicr

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“…The genotypes conferred resistance to β‐lactams ( pbp4 ), vancomycin ( vanB ), chloramphenicol ( cat ), macrolides ( ermB ), tetracycline ( tetM , tetL ), aminoglycosides ( acc6‐aph2 , aph(3)‐III , aant(4)Ia ) and ciprofloxacin ( gyrA , pyrC ) were characterized as described earlier (Araújo et al, ; Khani et al, ; Zahid, Bin‐Asif, Hasan, Rehman, & Ali, ). Primer sets, PBP4‐f 5′‐CCA‐CTT‐ATT‐CTT‐GGT‐GTT‐TCT‐G‐3′ and PBP4‐r 5′‐CTT‐TCA‐TTT‐CGC‐CTA‐AAG‐GAG‐TG‐3′ for the detection of penicillin binding protein ( pbp4 ) was design from reference sequence (GenBank: AJ290435.1).…”

Section: Methodsmentioning

confidence: 99%

“…Enterococcus faecalis is a commensal organism found in poultry and the human gastrointestinal tract. In recent years, E. faecalis has emerged as a major zoonotic and nosocomial pathogen (~70%–80% cases) which infects animals and humans alike (Khani, Fatollahzade, Pajavand, Bakhtiari, & Abiri, ; Semedo‐Lemsaddek, Tavares, São Braz, Tavares, & Oliveira, ). Indeed, the dual nature of Enterococcus sp.…”

Section: Introductionmentioning

confidence: 99%

The unravelled Enterococcus faecalis zoonotic superbugs: Emerging multiple resistant and virulent lineages isolated from poultry environment

Hasan

Ali

Rehman

et al. 2018

Zoonoses and Public Health

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This study aimed to investigate the zoonotic potential by virtue of phylogenetic analysis, virulence and resistance gene profiles of Enterococcus faecalis originating from poultry environment. The ERIC, BOX and RAPD PCR analysis showed the clustering of E. faecalis strains (n = 74) into five groups (G1-G5) and fifteen sub-clusters (B1-B15), which share 50%-80% similarities with ATCC E. faecalis and clinical strains of human infection. E. faecalis strains harboured seven enterocins genes including ent1097 (85%), entB (84%), enterolysinA (51%), entSEK4 (51%), entL50 (31%), entA (25.7%) and ent1071 (14.9%). The highest prevalence of gelE-sprE (90%), lip-fl (90%) followed by cylL (62%), hyl (60%), katA (16%) and cylA (5.4%) was observed in poultry isolates. The fsr operon and gelE-sprE was co-associated in 66.2% strains. E. faecalis also harboured biofilm and endocarditis-associated genes, including efaAfs (97%), ebp-pilli (ebpABC and srtC 69.9%-80%), asa1 (71%), agg (55%), ace (54%) and esp-Tim (3%). Despite all found sensitive to vancomycin, 98.6% strains were multi-drug resistant to five to twelve tested antimicrobials. An increased-level of resistance (≥32 μg/ml) was observed to ampicillin (8.1%), meropenem (21.6%), chloramphenicol (73.4%), erythromycin (90.5%), tetracycline (100%) and high-level resistance to kanamycin (79.7%) and gentamicin (52.7%). The multi-drug resistant E. faecalis (MDRe.f) were carried pbp4 (90%), tetL (90%), tetM (70%), ermB (81%), cat (52.7%), acc6-aph2 (58.1%), aaph(3)-III (49.9%), gyrA (97%) and parC (98%) genes. Moreover, these MDRe.f were also harboured, hospital-associated marker IS16 (58%) and pheromone responsive genes, that is ccf (88%), cpd (74%), cob (62%) and eep (66%). Thus, regardless of the distinct phylogenetic background of E. faecalis of poultry origin, ATCC E. faecalis and clinical strains of human origin, we found major similarities in virulence, resistance gene profiles and mobile genetic elements (IS16 and pheromone responsive plasmids), supporting the zoonotic/reverse zoonotic risk associated with this organism.

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“…PCR and MLST. PCR amplification of the 16S rRNA gene, MLST housekeeping genes, tetS, tetM, aph(3=)-IIIa, and aac(6=)-aph(2Љ) was performed using previously published primers and protocols (Table 7) (38)(39)(40)(41)(42). PCR primers for mutL and str were designed using the Primer-BLAST tool (https://www.ncbi .nlm.nih.gov/tools/primer-blast/).…”

Section: Methodsmentioning

confidence: 99%

Long-Term Colonization Dynamics of Enterococcus faecalis in Implanted Devices in Research Macaques

Lieberman

Tyne

Dzink-Fox

et al. 2018

Appl Environ Microbiol

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is a common opportunistic pathogen that colonizes cephalic recording chambers (CRCs) of macaques used in cognitive neuroscience research. We previously characterized 15 strains isolated from macaques at the Massachusetts Institute of Technology (MIT) in 2011. The goal of this study was to examine how a 2014 protocol change prohibiting the use of antimicrobials within CRCs affected colonizing strains. We collected 20 isolates from 10 macaques between 2013 and 2017 for comparison to 4 isolates previously characterized in 2011 with respect to the sequence type (ST) distribution, antimicrobial resistance, biofilm formation, and changes in genes that might confer a survival advantage. ST4 and ST55 were predominant among the isolates characterized in 2011, whereas the less antimicrobial-resistant lineage ST48 emerged to dominance after 2013. Two macaques remained colonized by ST4 and ST55 strains for 5 and 4 years, respectively. While the antimicrobial resistance and virulence factors identified in these ST4 and ST55 strains remained relatively stable, we detected an increase in biofilm formation ability over time in both isolates. We also found that ST48 strains were typically robust biofilm formers, which could explain why this ST increased in prevalence. Finally, we identified mutations in the DNA mismatch repair genes and in separate ST55 and ST4 strains and confirmed that strains bearing these mutations displayed a hypermutator phenotype. The presence of a hypermutator phenotype may complicate future antimicrobial treatment for clinically relevant infections in macaques. is a common cause of health care-associated infections in humans, largely due to its ability to persist in the hospital environment, colonize patients, acquire antimicrobial resistance, and form biofilms. Understanding how enterococci evolve in health care settings provides insight into factors affecting enterococcal survival and persistence. Macaques used in neuroscience research have long-term cranial implants that, despite best practices, often become colonized by This provides a unique opportunity to noninvasively examine the evolution of enterococci on a long-term indwelling device. We collected strains from cephalic implants over a 7-year period and characterized the sequence type, antimicrobial resistance, virulence factors, biofilm production, and hypermutator phenotypes. Improved antimicrobial stewardship allowed a less-antimicrobial-resistant strain to predominate at the implant interface, potentially improving antimicrobial treatment outcomes if future clinical infections occur. Biofilm formation appears to play an important role in the persistence of the strains associated with these implants.

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Increasing Prevalence of Aminoglycoside-Resistant Enterococcus faecalis Isolates Due to the aac(6’)-aph(2”) Gene: A Therapeutic Problem in Kermanshah, Iran

Cited by 17 publications

References 24 publications

High prevalence of vancomycin and high-level gentamicin resistance in Enterococcus faecalis isolates

High prevalence of vancomycin and high-level gentamicin resistance in Enterococcus faecalis isolates

The unravelled Enterococcus faecalis zoonotic superbugs: Emerging multiple resistant and virulent lineages isolated from poultry environment

Long-Term Colonization Dynamics of Enterococcus faecalis in Implanted Devices in Research Macaques

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