Detection and molecular characterization of VRE isolates in Slovakia from stool samples positive for Clostridioides difficile toxins.

The study aimed to identify colonized patients as a possible source of eventual VRE (vancomycin-resistant enterococci) infection from stool samples positive for glutamate dehydrogenase antigen, as well as for Clostridioides difficile toxins A and B. The study was carried out from 7/2020 to 9/2021. Stool samples were grown in a brain heart infusion medium with a gram-positive non-spore-forming bacteria supplement under aerobic conditions. The samples for VRE identification were grown on CHROMID® VRE agar, and the MICs for vancomycin and teicoplanin were also estimated. The presence of the vanA/vanB genes was tested using the PCR method. The total number of 113 stool samples positive for Clostridioides difficile toxins was analyzed. Of these samples, 44 isolates with VRE characters were identified. The most prevalent isolates in our set of isolates were Enterococcus faecium (27 isolates, 62%), Enterococcus faecalis (9 isolates, 21%), Enterococcus solitarius (4 isolates, 9%), Enterococcus durans (2 isolates, 4%), 1 isolate Enterococcus sulfurous (2%), and Enterococcus raffinosus (2%). In total, 26 isolates were detected in the study in the presence of vanA genes (24 isolates E. faecium, 2 isolates E. faecalis) and 18 isolates detected in the presence of vanB genes (7 isolates E. faecalis, 4 isolates E. solitarius, 3 isolates E. faecium, 2 isolates E. durans, 1 isolate E. sulfurous, and E. raffinosus). The results of this study showed the local dominance character of the vanA gene of hospital VRE isolates that were carriers of genes associated with high resistance to vancomycin, teicoplanin, and occasionally linezolid.

Changes in antibiotic resistance of respiratory pathogens in the Slovak Republic.

Respiratory tract infections are one of the most common reasons for public sickness rate. Even though they are usually virus-caused, antibiotic prescription is mostly used in primary care. The increase of resistance of bacterial strains observed in the last decade has much to do with this. This increase is connected mainly with the increasing antibiotics consumption and their selective pressure. That is why in many countries, there is an effort to stop this increase by reducing the useless prescription from etiology point of view. This paper points out a more careful approach to acute bacterial rhinosinusitis treatment in the community, taking into consideration the worsening condition of antibiotics resistance in Slovakia and Europe.

Changes of antimicrobial resistance and extended-spectrum beta-lactamase production in Klebsiella spp. strains.

Changes of antimicrobial resistance and extended-spectrum beta-lactamase (ESBL) production of Klebsiella spp. strains isolated at the Central Military Hospital, Ruzomberok, Slovakia, with a special focus on the Anesthesiology--Resuscitation and Intensive Medicine Department during the years 1998-2002, were analyzed. Of 3920 gram-negative strains isolated from clinical materials during this period, Klebsiella spp. represented 8%. The incidence of ESBL-producing Klebsiella spp. isolates increased from 29% in 1998 to 69% in 2002. Of 17 antibiotics tested, meropenem was found to be the most effective drug (100%). The overall efficacy of cefotaxime was 31%, that of gentamicin 23%, and that of ciprofloxacin 54%. Analyzed Klebsiella isolates were characterized also by a high degree of multiresistance (53%). The high incidence of reduced antibiotic susceptibility among Klebsiella spp. strains isolated at the intensive-care department suggests that more effective strategies are necessary to control the selection and spread of resistant organisms in this hospital.