Emergence of multidrug resistance and extensive drug resistance among enterococcal clinical isolates in Egypt

Enterococci commonly inhabit the gastrointestinal tract of both human and animals; however, they have emerged as a leading cause of several infections with substantial morbidity and mortality. Their ability to acquire resistance combined with intrinsic resistance to various antimicrobials makes trea...

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Bibliographic Details
Published in:Infection and drug resistance 2019-05, Vol.12, p.1113-1125
Main Authors: Said, Heba Shehta, Abdelmegeed, Eman Salama
Format: Article
Language:English
Subjects:
Aminoglycosides
Antibacterial agents
antibiotic resistance
Antibiotics
biofilm formation
Drug resistance
Drug therapy
Egypt
Enterococcal infections
Enterococci
Gastrointestinal system
Genes
Health aspects
Hospital patients
Hospitals
Imipenem
Infection
Linezolid
Linezolid resistant enterococci
MDR enterococci
Meropenem
Microbial drug resistance
Morbidity
Original Research
RAPD typing
Tetracyclines
Vancomycin
VRE
XDR enterococci
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Summary:Enterococci commonly inhabit the gastrointestinal tract of both human and animals; however, they have emerged as a leading cause of several infections with substantial morbidity and mortality. Their ability to acquire resistance combined with intrinsic resistance to various antimicrobials makes treatment of enterococcal infections challenging. The aim of the study was to evaluate the antimicrobial resistance pattern, and assess the prevalence of multidrug resistance (MDR) and extensive drug resistance (XDR) among enterococcal isolates, collected from different clinical sources, in Mansoura University Hospitals, Egypt. Antibiotic sensitivity testing revealed elevated levels of resistance among enterococcal clinical isolates (N=103). All (N=32) and 74.6% of (N=71) were MDR, while two and four isolates were XDR. High level gentamicin resistance was detected in 79.6%, most of them carried the gene. High level streptomycin resistance was seen in 36.9%, of which 52.6% carried the gene. Resistance to macrolides and lincosamides were mediated by (92.2%) and (42.7%). , , and genes were detected among tetracyclines resistant isolates. Resistance to vancomycin was detected in 15.5%, where and gene clusters were detected in VRE isolates. Ten isolates (9.7%) were resistant to linezolid, eight of which harbored the gene. Vancomycin and linezolid resistant enterococci were more likely to exhibit strong/moderate biofilm formation than vancomycin and linezolid sensitive ones. Elevated levels of resistance to different classes of antimicrobial agents and emergence of MDR and XDR strains pose a major threat with limited therapeutic options for infections caused by this emerging pathogen.
ISSN:1178-6973
1178-6973
DOI:10.2147/IDR.S189341