RESUMO
In this study we report the first isolation of VanA-type vancomycin-resistant Enterococcus faecalis strains from two different patients hospitalized in the same intensive care unit at the hospital of Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Enterococcus faecalis/genética , Enterococcus faecalis/isolamento & purificação , Infecções por Bactérias Gram-Positivas , Técnicas In Vitro , Resistência a Vancomicina/genética , Técnicas e Procedimentos Diagnósticos , Genótipo , Métodos , Pacientes , Prevalência , VirulênciaRESUMO
In this study we report the first isolation of VanA-type vancomycin-resistant Enterococcus faecalis strains from two different patients hospitalized in the same intensive care unit at the hospital of Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil.
RESUMO
OBJECTIVES: To report the isolation of six Staphylococcus hominis subsp. novobiosepticus (SHN) strains from hospitalized patients with bloodstream infections in two Brazilian hospitals and to characterize their susceptibility profile to several antimicrobials. METHODS: Species identification was performed by biochemical methods and sodA gene sequencing. The MICs of antimicrobials were determined by broth and agar dilution methods and by Etest. Isolates were typed by PFGE and PCR amplification was used to detect the ccr gene complex and the mec class. Morphometric evaluation of cell wall was performed by transmission electron microscopy (TEM). RESULTS: Susceptibility profiles indicated that the majority of isolates (five) were multidrug-resistant. Overlapping and multiplex PCR showed that five out of the six strains harboured SCCmec type III with class A mec and type 3 ccr. The initial vancomycin MIC value of 4 mg/L for these strains increased to 16-32 mg/L after growth for 10 days in BHI broth supplemented with this antimicrobial. TEM indicated that vancomycin resistance was associated with cell wall thickening and to another mechanism not fully elucidated. Only one SHN strain was oxacillin- and vancomycin-susceptible. The nosocomial infections in at least five of the patients from both hospitals were caused by a single clone of SHN. CONCLUSIONS: It is very important to consider SHN strains as the cause of nosocomial infections. The clinical implications resulting from the pattern of multidrug resistance in these strains may be complicated by the emergence of vancomycin resistance.
Assuntos
Bacteriemia/microbiologia , Infecção Hospitalar/microbiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus hominis/isolamento & purificação , Antibacterianos/farmacologia , Bacteriemia/epidemiologia , Proteínas de Bactérias/genética , Técnicas de Tipagem Bacteriana , Brasil/epidemiologia , Parede Celular/ultraestrutura , Análise por Conglomerados , Infecção Hospitalar/epidemiologia , Impressões Digitais de DNA , Farmacorresistência Bacteriana Múltipla , Eletroforese em Gel de Campo Pulsado , Genótipo , Hospitais , Humanos , Testes de Sensibilidade Microbiana , Microscopia Eletrônica de Transmissão , Reação em Cadeia da Polimerase , Análise de Sequência de DNA , Infecções Estafilocócicas/epidemiologia , Staphylococcus hominis/classificação , Staphylococcus hominis/efeitos dos fármacos , Staphylococcus hominis/genética , Superóxido Dismutase/genéticaRESUMO
Three Enterococcus faecalis and one Enterococcus faecium strains were characterized by plasmid profile, pulsed-field gel electrophoresis (PFGE) and determination of antimicrobial minimal inhibitory concentrations. VanA elements were characterized by Long PCR, overlapping PCR and DNA sequencing. Enterococcal strains showed resistance to vancomycin and harbored the vanA gene, and three these were teicoplanin susceptible while one showed intermediate resistance to teicoplanin. Two E. faecalis strains showed indistinguishable PFGE profile while the third was unrelated. E. faecalis strains showed a deletion in the right terminal region of the Tn1546-like element. The E. faecium strain showed an insertion element in the vanXY intergenic region. Mutations in VanA elements were not found. Rearrangements in the VanA element could be responsible for incongruities in genotype and phenotype in these strains.
Assuntos
Antibacterianos/farmacologia , Enterococcus faecalis , Enterococcus faecium , Teicoplanina/farmacologia , Vancomicina/farmacologia , Proteínas de Bactérias/genética , Brasil , Carbono-Oxigênio Ligases/genética , DNA Bacteriano/genética , Eletroforese em Gel de Campo Pulsado , Enterococcus faecalis/efeitos dos fármacos , Enterococcus faecalis/genética , Enterococcus faecalis/isolamento & purificação , Enterococcus faecium/efeitos dos fármacos , Enterococcus faecium/genética , Enterococcus faecium/isolamento & purificação , Genótipo , Humanos , Testes de Sensibilidade Microbiana , Fenótipo , Reação em Cadeia da Polimerase , Análise de Sequência de DNA , Resistência a Vancomicina/genéticaRESUMO
Three Enterococcus faecalis and one Enterococcus faecium strains were characterized by plasmid profile, pulsed-field gel electrophoresis (PFGE) and determination of antimicrobial minimal inhibitory concentrations. VanA elements were characterized by Long PCR, overlapping PCR and DNA sequencing. Enterococcal strains showed resistance to vancomycin and harbored the vanA gene, and three these were teicoplanin susceptible while one showed intermediate resistance to teicoplanin. Two E. faecalis strains showed indistinguishable PFGE profile while the third was unrelated. E. faecalis strains showed a deletion in the right terminal region of the Tn1546-like element. The E. faecium strain showed an insertion element in the vanXY intergenic region. Mutations in VanA elements were not found. Rearrangements in the VanA element could be responsible for incongruities in genotype and phenotype in these strains.
Assuntos
Humanos , Antibacterianos/farmacologia , Enterococcus faecalis , Enterococcus faecium , Teicoplanina/farmacologia , Vancomicina/farmacologia , Brasil , Proteínas de Bactérias/genética , Carbono-Oxigênio Ligases/genética , DNA Bacteriano/genética , Eletroforese em Gel de Campo Pulsado , Enterococcus faecalis/efeitos dos fármacos , Enterococcus faecalis/genética , Enterococcus faecalis/isolamento & purificação , Enterococcus faecium/efeitos dos fármacos , Enterococcus faecium/genética , Enterococcus faecium/isolamento & purificação , Genótipo , Testes de Sensibilidade Microbiana , Fenótipo , Reação em Cadeia da Polimerase , Análise de Sequência de DNA , Resistência a Vancomicina/genéticaRESUMO
The isolation of vancomycin resistant enterococci (VRE) in Brazil has rapidly increased, following the world wide tendency. We report in the present study the first isolation of vancomycin resistant Enterococcus faecalis (VRE) in the Northeast of Brazil. The four VRE isolates were characterized for antimicrobial susceptibility, genotypic typing by macro restriction of chromosomal DNA followed by pulsed-field gel electrophoresis and for characterization of the Tn1546-like element and plasmid contents. The isolates showed resistance to multiple antibiotics and a single genotype profile, suggesting the dissemination of a single clone among the patients. Tn1546 associated to genetic elements as plasmids shows the importance of infection control measures to avoid the spreading of glycopeptide resistance by conjugative transfer of VanA elements.
Assuntos
Proteínas de Bactérias/genética , Carbono-Oxigênio Ligases/genética , Infecção Hospitalar/microbiologia , Enterococcus faecalis/genética , Infecções por Bactérias Gram-Positivas/microbiologia , Resistência a Vancomicina/genética , Técnicas de Tipagem Bacteriana , Brasil , Infecção Hospitalar/diagnóstico , DNA Bacteriano/análise , Eletroforese em Gel de Campo Pulsado , Enterococcus faecalis/efeitos dos fármacos , Enterococcus faecalis/isolamento & purificação , Genótipo , Infecções por Bactérias Gram-Positivas/diagnóstico , Humanos , Testes de Sensibilidade MicrobianaRESUMO
The isolation of vancomycin resistant enterococci (VRE) in Brazil has rapidly increased, following the world wide tendency. We report in the present study the first isolation of vancomycin resistant Enterococcus faecalis (VRE) in the Northeast of Brazil. The four VRE isolates were characterized for antimicrobial susceptibility, genotypic typing by macro restriction of chromosomal DNA followed by pulsed-field gel electrophoresis and for characterization of the Tn1546-like element and plasmid contents. The isolates showed resistance to multiple antibiotics and a single genotype profile, suggesting the dissemination of a single clone among the patients. Tn1546 associated to genetic elements as plasmids shows the importance of infection control measures to avoid the spreading of glycopetide resistance by conjugative transfer of VanA elements.
Assuntos
Humanos , Proteínas de Bactérias , Carbono-Oxigênio Ligases/genética , Infecção Hospitalar/microbiologia , Enterococcus faecalis/genética , Infecções por Bactérias Gram-Positivas/microbiologia , Resistência a Vancomicina , Técnicas de Tipagem Bacteriana , Brasil , Infecção Hospitalar/diagnóstico , DNA Bacteriano/análise , Eletroforese em Gel de Campo Pulsado , Enterococcus faecalis/efeitos dos fármacos , Enterococcus faecalis/isolamento & purificação , Genótipo , Infecções por Bactérias Gram-Positivas/diagnóstico , Testes de Sensibilidade MicrobianaRESUMO
This study reports the results about antimicrobial resistance of Enterococcus spp. isolated from intestinal tract of patients from a university hospital in Brazil. The identification of strains at species level was performed by conventional biochemical tests, API 20 Strep (bioMérieux), and polymerase chain reaction assay. The specie distribution was E. faecium (34 percent), followed by E. faecalis (33 percent), E. gallinarum (23.7 percent), E. casseliflavus (5.2 percent), E. avium (1 percent), and E. hirae (1 percent). Intrinsic resistance to vancomycin characterized by presence of vanC genes was found in E. gallinarum and E. casseliflavus. The high prevalence of VanC phenotype enterococci is very important because these species have been reported as causing a wide variety of infections. Vancomycin-resistant E. faecium or E. faecalis were not found and no one isolate of these species was a beta-lactamase producer. Thirteen clinical isolates of enterococci (13.4 percent) showed multiresistance patterns, which were defined by resistance to three classes of antibiotics plus resistance to at least one aminoglycoside (gentamicin and/or streptomycin). The resistance to several antimicrobials shown by enterococcal strains obtained in this study is of concern because of the decrease in the therapeutic options for treatment of infections caused by enterococci.
Assuntos
Humanos , Antibacterianos , Farmacorresistência Bacteriana , Enterococcus , Infecções por Bactérias Gram-Positivas , Enteropatias , beta-Lactamases , Brasil , Fezes , Genótipo , Hospitais Universitários , Testes de Sensibilidade Microbiana , Reação em Cadeia da Polimerase , Resistência a VancomicinaRESUMO
This study reports the results about antimicrobial resistance of Enterococcus spp. isolated from intestinal tract of patients from a university hospital in Brazil. The identification of strains at species level was performed by conventional biochemical tests, API 20 Strep (bioMérieux), and polymerase chain reaction assay. The species distribution was E. faecium (34%), followed by E. faecalis (33%), E. gallinarum (23.7%), E. casseliflavus (5.2%), E. avium (1%), and E. hirae (1%). Intrinsic resistance to vancomycin characterized by presence of vanC genes was found in E. gallinarum and E. casseliflavus. The high prevalence of VanC phenotype enterococci is very important because these species have been reported as causing a wide variety of infections. Vancomycin-resistant E. faecium or E. faecalis were not found and no one isolate of these species was a beta-lactamase producer. Thirteen clinical isolates of enterococci (13.4%) showed multiresistance patterns, which were defined by resistance to three classes of antibiotics plus resistance to at least one aminoglycoside (gentamicin and/or streptomycin). The resistance to several antimicrobials shown by enterococcal strains obtained in this study is of concern because of the decrease in the therapeutic options for treatment of infections caused by enterococci.
