Species, antibiotic susceptibility profiles and van gene frequencies among enterococci isolated from patients at Mulago National Referral Hospital in Kampala, Uganda

Autor: Christine F. Najjuka, Frank Nobert Mwiine, David P. Kateete, Edgar Kigozi, Moses Edolu, Jeffrey Kisukye, Hannington Baluku
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
0301 basic medicine
VRE
Enterococcus faecium
Drug resistance
Polymerase Chain Reaction
Kampala-Uganda
chemistry.chemical_compound
0302 clinical medicine
Gene Frequency
Ampicillin
Enterococcus faecalis
Medicine
Uganda
030212 general & internal medicine
Referral and Consultation
Mulago hospital
biology
Vancomyicin resistant enterococci
Infectious Diseases
Carrier State
Vancomycin
Female
Research Article
medicine.drug
Adult
vanB
030106 microbiology
Microbial Sensitivity Tests
vanA
Vancomycin-Resistant Enterococci
Microbiology
lcsh:Infectious and parasitic diseases
Young Adult
03 medical and health sciences
Antibiotic resistance
Humans
lcsh:RC109-216
Secondary Care Centers
Gram-Positive Bacterial Infections
business.industry
Vancomycin Resistance
biochemical phenomena
metabolism
and nutrition
biology.organism_classification
bacterial infections and mycoses
Cross-Sectional Studies
Enterococcus
chemistry
Linezolid
bacteria
business
Zdroj: BMC Infectious Diseases, Vol 19, Iss 1, Pp 1-9 (2019)
BMC Infectious Diseases
ISSN: 1471-2334
Popis: Background The increase in drug resistance to affordable antibiotics used to treat Gram positive bacterial infections has complicated the management of enterococcal infections. Resistance to vancomycin, one of the most powerful antibiotics, is of utmost concern as both intrinsic and acquired forms of resistance do occur in enterococci. This cross-sectional study aimed to determine the species, antibiotic susceptibility profiles and vanA/vanB gene frequencies among enterococci isolated from patients at Mulago Hospital in Kampala, Uganda. Methods Between November 2011 and October 2012, stool, urine, sputum and blood samples, as well as vaginal, endocervical, pus, ear and urethra swabs from 3229 patients were processed for isolation of bacteria, yielding 162 enterococci of which 115 were available for analysis (one isolate per specimen/patient). Species-level confirmation and susceptibility testing were determined with the Phoenix™ AST/ID Automated System, while vanA/vanB gene carriage was determined by PCR. Results Species-level identification revealed 72 isolates of E. faecalis, 20 E. gallinarum/casseliflavus, 5 E. faecium, 4 E. raffinosus and 2 isolates each for E. hirae and E. durans. Ten isolates could not be identified to species level. Antibiotic resistance was generally low especially to ampicillin, quinolones, nitrofurantoin, glycopeptides and linezolid, but high for erythromycin and tetracycline. Equally, vanA and vanB gene frequencies were low (i.e. 15.8 and 7.9%, respectively) and detected only in E. casseliflavus/gallinarum species that are intrinsically resistant to vancomycin. Vancomycin resistant isolates of E. faecalis and E. faecium were not detected. Conclusions Enterococcus species are frequent in clinical specimens at Mulago Hospital but they are highly susceptible to common antibiotics especially ampicillin. While vancomycin resistant enterococcal (VRE) isolates of E. faecium and E. faecalis are rare in the hospital and frequency of multidrug resistance is low, non-faecium and non-faecalis VRE isolates (i.e. E. gallinarum/casseliflavus) are frequent, some with VanA/VanB (high-level) vancomycin resistance. Therefore, species-level identification of enterococci is necessary in resource limited settings to guide infection control and treatment of enterococcal infections. Electronic supplementary material The online version of this article (10.1186/s12879-019-4136-7) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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