Surface protein Esp enhances pro-inflammatory cytokine expression through NF-κB activation during enterococcal infection

Zou, Jun; Shankar, Nathan

doi:10.1177/1753425915611237

Cited by 20 publications

(12 citation statements)

References 39 publications

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“…Similar observations have been reported in E. faecalis isolates as well [45]. Recent data have also shown that the induction of the expression of pro-inflammatory cytokines was initiated by esp via the activation of the NF-ĸB pathway in vitro [46]. However, the exact mechanism of the activation is still unknown.…”

Section: Discussionsupporting

confidence: 77%

Antibiotic Susceptibility Patterns, Biofilm Formation and esp Gene among Clinical Enterococci: Is There Any Association?

Weng¹,

Ramli²,

Hamat³

2019

IJERPH

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Enterococci are commonly found in humans, animals and environments. Their highly adaptive mechanisms are related to several virulent determinants and their ability to resist antibiotics. Data on the relationship between the esp gene, biofilm formation and antibiotic susceptibility profiles may differ between countries. This cross-sectional study was conducted to determine the proportion of esp gene and biofilm formation among Enterococcus faecalis and Enterococcus faecium clinical isolates. We also investigated the possible association between the esp gene with antibiotic susceptibility patterns and biofilm formation. The isolates were collected from clinical samples and identified using biochemical tests and 16SRNA. Antibiotic susceptibility patterns and a biofilm assay were conducted according to the established guidelines. Molecular detection by PCR was used to identify the esp gene using established primers. In total, 52 and 28 of E. faecalis and E. faecium were identified, respectively. E. faecium exhibited higher resistance rates compared to E. faecalis as follows: piperacillin/tazobactam (100% versus 1.9%), ampicillin (92.8% versus 1.9%), high-level gentamicin resistance (HLGR) (89.3% versus 25.0%) and penicillin (82.1% versus 7.7%). E. faecium produced more biofilms than E. faecalis (59.3% versus 49.0%). E. faecium acquired the esp gene more frequently than E. faecalis (78.6% versus 46.2%). Interestingly, the associations between ampicillin and tazobactam/piperacillin resistance with the esp gene were statistically significant (X2 = 4.581, p = 0.027; and X2 = 6.276, p = 0.012, respectively). Our results demonstrate that E. faecium exhibits high rates of antimicrobial resistance, esp gene acquisition and biofilm formation. These peculiar traits of E. faecium may have implications for the management of enterococcal infections in hospitals. Thus, concerted efforts by all parties in establishing appropriate treatment and effective control measures are warranted in future.

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Section: Discussionsupporting

confidence: 77%

Antibiotic Susceptibility Patterns, Biofilm Formation and esp Gene among Clinical Enterococci: Is There Any Association?

Weng¹,

Ramli²,

Hamat³

2019

IJERPH

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“…Ampicillin resistance is a phenotypic marker of these hospital-associated strain types [ 39 – 41 ]. It has been shown that AMP-R E. faecium isolates causing healthcare-associated infections are in fact more pathogenic than commensal variants [ 42 , 43 ]. In a supplementary analysis (Additional file 1 : Tables S1 and S2) we found that 95% of our E. faecium isolates were ampicillin-resistant (AMP-R), in contrast to only 1% of the E. faecalis isolates.…”

Section: Discussionmentioning

confidence: 99%

The importance of adjusting for enterococcus species when assessing the burden of vancomycin resistance: a cohort study including over 1000 cases of enterococcal bloodstream infections

Kramer

Remschmidt

Werner

et al. 2018

Antimicrob Resist Infect Control

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BackgroundInfections caused by vancomycin-resistant enterococci (VRE) are on the rise worldwide. Few studies have tried to estimate the mortality burden as well as the financial burden of those infections and found that VRE are associated with increased mortality and higher hospital costs. However, it is unclear whether these worse outcomes are attributable to vancomycin resistance only or whether the enterococcal species (Enterococcus faecium or Enterococcus faecalis) play an important role. We therefore aimed to determine the burden of enterococci infections attributable to vancomycin resistance and pathogen species (E. faecium and E. faecalis) in cases of bloodstream infection (BSI).MethodsWe conducted a retrospective cohort study on patients with BSI caused by Enterococcus faecium or Enterococcus faecalis between 2008 and 2015 in three tertiary care hospitals. Data was collected on true hospital costs (in €), length of stay (LOS), basic demographic parameters, and underlying diseases including the results of the Charlson comorbidity index (CCI). We used univariate and multivariable regression analyses to compare risk factors for in-hospital mortality and length of stay (i) between vancomycin-susceptible E. faecium- (VSEm) and vancomycin-susceptible E. faecalis- (VSEf) cases and (ii) between vancomycin-susceptible E. faecium- (VSEm) and vancomycin-resistant E. faecium-cases (VREm). We calculated total hospital costs for VSEm, VSEf and VREm.ResultsOverall, we identified 1160 consecutive cases of BSI caused by enterococci: 596 (51.4%) cases of E. faecium BSI and 564 (48.6%) cases of E. faecalis BSI. 103 cases of E. faecium BSI (17.3%) and 1 case of E. faecalis BSI (0.2%) were infected by vancomycin-resistant isolates. Multivariable analyses revealed (i) that in addition to different underlying diseases E. faecium was an independent risk factor for in-hospital mortality and prolonged hospital stay and (ii) that vancomycin-resistance did not further increase the risk for the described outcomes among E. faecium-isolates. However, the overall hospital costs were significantly higher in VREm-BSI cases as compared to VSEm- and VSEf-BSI cases (80,465€ vs. 51,365€ vs. 31,122€ p < 0.001).ConclusionOur data indicates that in-hospital mortality and infection-attributed hospital stay in enterococci BSI might rather be influenced by Enterococcus species and underlying diseases than by vancomycin resistance. Therefore, future studies should consider adjusting for Enterococcus species in addition to vancomycin resistance in order to provide a conservative estimate for the burden of VRE infections.Electronic supplementary materialThe online version of this article (10.1186/s13756-018-0419-9) contains supplementary material, which is available to authorized users.

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“…Enterococcus surface protein (esp) is a virulence factor that helps in the adhesion, but its role in biofilm formation is still opposing (Shridhar and Dhanashree, 2019). Esp is encoded on a pathogenicity island in E. faecalis and is involved in biofilm formation and binding to epithelial cells (Zou and Shankar, 2016). E. faecalis surface protein (Esp) is known to help surface attachment leading to biofilm development.…”

Section: Detection Of Esp Gene By Pcrmentioning

confidence: 99%

Molecular and Bacteriological Study of Enterococcus faecalis Isolated from Different Clinical Sources

Khdir

Mustafa

2020

ZJPAS

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Enterococci are Gram-positive bacteria that cause serious nosocomial infections, including urinary tract, bloodstream infections and endocarditis. During the period of September 2018 to February 2019, forty four isolates of E. faecalis were isolated from 826 clinical specimens including; 35(5.07%) isolates of E. faecalis from urine, 7(7.60%) isolates from high vaginal swab and 2(8.69%) isolates from blood patients in different hospitals. All isolates that described above were identified depending on cultural criteria, morphological criteria, biochemical tests and further confirmed by Vitek 2 compact systems. The results of eleven antimicrobial against obtained isolates revealed that 100% of E. faecalis were resistant to cefotaxime, vancomycin, amoxicillin and erythromycin. While, it were 100% sensitive to doxycycline, imipenem, and nitrofurantion. Whereas, most isolates were differ in their susceptibility to amikacin, gentamycin, tetracycline and azithromycin. On the other hand, the results of biofilm found that 13.63% of isolates were produce strong biofilm, 54.54% were produce moderate biofilm and 31.81% were produce weak biofilm. The results of molecular analysis by using PCR showed that isolated E. faecalis were carried 97.72%, 90.90%, 63.63% of ebpR, asa1, esp genes respectively.

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Surface protein Esp enhances pro-inflammatory cytokine expression through NF-κB activation during enterococcal infection

Cited by 20 publications

References 39 publications

Antibiotic Susceptibility Patterns, Biofilm Formation and esp Gene among Clinical Enterococci: Is There Any Association?

Antibiotic Susceptibility Patterns, Biofilm Formation and esp Gene among Clinical Enterococci: Is There Any Association?

The importance of adjusting for enterococcus species when assessing the burden of vancomycin resistance: a cohort study including over 1000 cases of enterococcal bloodstream infections

Molecular and Bacteriological Study of Enterococcus faecalis Isolated from Different Clinical Sources

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