Risk factors for vancomycin-resistant Enterococcus colonization in hematologic patients

Mioljević, Vesna; Marković-Denić, Ljiljana; Vidovic, Ana; Jovanović, M.; Tošić, Tanja; Tomin, Dragica

doi:10.2298/vsp1312109m

Cited by 10 publications

(8 citation statements)

References 23 publications

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“…However, the years of lax restriction and enforcement together with the fact that antibiotics were sold in pharmacies to anyone who could afford them could and probably did lead to a higher incidence of antibioticresistant strains, including enterococci. Vancomycinresistant enterococci (VRE) are designated as pathogens of great importance in Serbian hospitals (Mioljevic et al 2013;Stosovic et al 2004). Although most VRE infections are nosocomial, environmental contamination with VRE is of special interest since enterococci are ubiquitously detected in aquatic environments where they are able to survive long period of time (Nishiyama et al 2015).…”

Section: Introductionmentioning

confidence: 99%

“…Although most VRE infections are nosocomial, environmental contamination with VRE is of special interest since enterococci are ubiquitously detected in aquatic environments where they are able to survive long period of time (Nishiyama et al 2015). Accordingly, we analyzed surface water samples from the Belgrade area in which hospitals VRE were previously described (Mioljevic et al 2013;Stosovic et al 2004) in order to determine whether the environment pool of multiresistant enterococci and VRE.…”

Section: Introductionmentioning

confidence: 99%

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Environmental waters as a source of antibiotic-resistant Enterococcus species in Belgrade, Serbia

Veljović

Popović

Vidojević

et al. 2015

Environ Monit Assess

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Despite the number of studies on antibiotic-resistant enterococci from Serbian clinical settings, there are no data about environmental contamination with these bacteria. Thus, this study investigated the prevalence of antibiotic-resistant enterococci in Belgrade, Serbia. Enterococcus species collected from ten surface water sites, including a lake, two major river systems, and springs, were tested. Among enterococci, we found single (21.7 %), double (17.4 %), and multiple antibiotic resistance patterns (56.3 %). Vancomycin-resistant strains were not found, indicating that their abundance in Belgrade is tightly linked to clinical settings. The multiple drug-resistant strains Enterococcus faecalis, Enterococcus faecium, and Enterococcus mundtii were frequently detected in the lake during the swimming season and in the rivers near industrial zones. We confirmed the presence of ermB, ermC, ant(6)-Ia, tetM, and tetL and mutations in gyrA genes. The phylogenetic analysis of 16S rRNA gene of E. faecium isolates that harbor esp gene classified them into two groups based on high-bootstraps scores in the tree analysis. Pulsed-field gel electrophoresis analysis of antibiotic-resistant enterococci revealed genomic similarity ranging from 75 to 100 %. This study indicates the importance of anthropogenic impact to the spread of antibiotic-resistant enterococci in environmental waters of Belgrade, Serbia.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Environmental waters as a source of antibiotic-resistant Enterococcus species in Belgrade, Serbia

Veljović

Popović

Vidojević

et al. 2015

Environ Monit Assess

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“…When interpreting the MIC/disk diffusion results, it is important to ensure that isolate is not E. casselifalvus or E. gallinarum, species that possess intrinsic resistance to glycopeptides. Furthermore, despite the number of studies on antibiotic-resistance in enterococci from Serbian clinical settings, there were no data about prevalence of VRE in the outpatients' settings in our country [18,19,20]. The results of the Central Asian and Eastern European Surveillance of Antimicrobial Resistance (CAESAR network) [7] showed high level of resistance to aminopenicillins among E. faecalis and E. faecium (41% and 94%, respectively).…”

Section: Discussionmentioning

confidence: 95%

The phenotypic and genotypic characterization of vancomycin-resistant enterococci in outpatients’ urine culture

et al. 2017

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Introduction/Objective In the era of emerging antibacterial resistance, the major burden of resistant strains is on hospitalized patients. Although community factors are also important in the spread of resistance, less attention has been paid to non-healthcare settings. The aim of the study is to determine the prevalence of vancomycin-resistant enterococci (VRE) in the outpatient's urine culture and to perform phenotypic and genotypic characterization of VRE strains. Methods During an 18-month period, a total of 5,164 Enterococcus spp. strains were isolated from urine and identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antimicrobial susceptibility testing was performed by disk diffusion method and by gradient test for glycopeptideresistant strains. Genotypic characterization of VRE strains was done by multiplex polymerase chain reaction for the detection of the vancomycin resistance genes. Results Among the isolated enterococci, 5,060 (98%) were E. faecalis and 104 (2%) were E. faecium. E. faecalis strains were susceptible to all tested antibiotics except norfloxacin (33% of strains were resistant), while E. faecium showed high level of resistance to most of the tested agents (91.3% to ampicillin, 77% to norfloxacin, and 75% to nitrofurantoin), and 26% of strains were resistant to vancomycin and teicoplanin. VanA gene was detected in all vancomycin resistant E. faecium (VREfm) strains. Conclusion A high proportion of VREfm was noticed among outpatients in our country. All analyzed VREfm strains belonged to vanA genotype. Future surveillance studies of VRE are needed to follow up on this baseline study to monitor any possible changes in abundance and genotype of VRE in this population group.

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“…Vancomycin (184,471), ampicillin (472), linezolid (35), teicoplanin (473), piperacillin (474), cephalosporins (64), multidrug resistant (184) Catheter-associated-UTI, Nitrofurantoin b (481), fosfomycin (482), linezolid (480), daptomycin (18), chloramphenicol (483), doxycycline (483), high-dose ampicillin and sulbactam (483), omadacycline (396) 10% of all HA bloodstream infections (484,485); tolerant to heat, chlorine, and alcohol preparations (486); E. faecium demonstrates significantly higher levels of resistance than E. faecalis (35); commonly encountered as asymptomatic colonization (487) Methicillin-resistant S.…”

Section: Enterococcusmentioning

confidence: 99%

Antimicrobial Resistance in ESKAPE Pathogens

et al. 2020

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SUMMARY Antimicrobial-resistant ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) pathogens represent a global threat to human health. The acquisition of antimicrobial resistance genes by ESKAPE pathogens has reduced the treatment options for serious infections, increased the burden of disease, and increased death rates due to treatment failure and requires a coordinated global response for antimicrobial resistance surveillance. This looming health threat has restimulated interest in the development of new antimicrobial therapies, has demanded the need for better patient care, and has facilitated heightened governance over stewardship practices.

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Risk factors for vancomycin-resistant Enterococcus colonization in hematologic patients

Abstract: VRE colonization rate was high among the patients admitted to hematology ICU. Rational use of antibiotics and active surveillance may be helpful preventive measures against the development of bacterial resistance to antimicrobial agents.

Cited by 10 publications

References 23 publications

Environmental waters as a source of antibiotic-resistant Enterococcus species in Belgrade, Serbia

Environmental waters as a source of antibiotic-resistant Enterococcus species in Belgrade, Serbia

The phenotypic and genotypic characterization of vancomycin-resistant enterococci in outpatients’ urine culture

Antimicrobial Resistance in ESKAPE Pathogens

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