head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2019, vol. 25, issue3
Subject Area: Medicine
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DOI: 10.5272/jimab.2019253.2649
Published online: 05 August 2019

Original article

J of IMAB. 2019 Jul-Sep;25(3):2649-2654;
ENTEROCOCCUS AND ENTEROCOCCUS-LIKE ORGANISMS RECOVERED IN FAECAL SCREENING FOR VANCOMYCIN-RESISTANCE
Hristina Y. HitkovaORCID logo Corresponding Autoremail, Preslava M. HristovaORCID logo,
Department of Microbiology, Virology and Medical Genetics, Faculty of Pharmacy, Medical University - Pleven, Bulgaria.

ABSTRACT:
Background: Fecal screening of patients for vancomycin-resistant enterococci (VRE) is recommended in an attempt to establish infection control measures. Culture-based methods for VRE detection are widely used, but particular attention should be paid to correct identification of growing isolates. This study is focused on species identification and antimicrobial susceptibility of vancomycin-resistant enterococci and other Gram-positive catalase-negative cocci, recovered from VRE screen cultures.
Materials and methods: A total of 109 immunocompromised patients from University Multiprofile Hospital for Active Treatment “Dr G. Stranski”, Pleven were screened for VRE. The determination of cocci was relied on cultural characteristics, manual and automated systems for identification as well as data on antimicrobial sensitivity.
Results: A total of 57 Gram-positive catalase-negative cocci were isolated: 32 VRE, 11 vancomycin-susceptible enterococci and 14 enterococcus-like organisms. Colonization with VanA or VanC enterococci was detected in 29.35% of the patients, with a distinct prevalence of VanC (23.85%) over than VanA(5.50%). Six enterococci were confirmed as vanA genotype– 5 E. faecium and 1 E. gallinarum. All E. faecium isolates expressed high-level resistance to vancomycin (MICs ≥256 µg/ml) and low-level resistance to teicoplanin (MICs: 4.0-6.0 µg/ml), whereas a single E. gallinarum isolate showed MICs ≥256 µg/ml for both glycopeptides. The isolated VanC enterococci (13 E. gallinarum and13 E. casseliflavus) were susceptible to tested antibiotics and possessed low-level resistance to vancomycin (MICs: 4-12 µg/ml). Most of the recovered enterococcus-like organisms were identified as Leuconostoc spp.
In conclusion, both species identification and antimicrobial susceptibility pattern have to be taken into account for distinguishing VRE and other Gram-positive catalase-negative cocci, growing in VRE screen cultures.

Keywords: VRE, enterococcus-like organisms, fecal screening,

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Please cite this article as: Hitkova HY, Hristova PM. Enterococcus and Enterococcus-like organisms recovered in faecal screening for vancomycin-resistance. J of IMAB. 2019 Jul-Sep;25(3):2649-2654. DOI: 10.5272/jimab.2019253.2649

Corresponding AutorCorrespondence to: Hristina Y. Hitkova, PhD, Department of Microbiology, Virology and Medical Genetics, Medical University – Pleven; 1, St. Kliment Ohridski str., 5800 Pleven, Bulgaria; E-mail: hitkova@abv.bg

REFERENCES:
1. Murray BE. The life and times of the Enterococcus. Clin Microbiol Rev. 1990 Jan;3(1):46-65. [Crossref]
2. Cattoir V, Leclercq R. Twenty-five years of shared life with vancomycin-resistant enterococci: is it time to divorce? J Antimicrob Chemother. 2013 Apr;68(4):731-42. [PubMed] [Crossref]
3. Faron LM, Ledeboer AN, Buchan WB. Resistance mechanisms, epidemiology, and approaches to screening for vancomycin-resistant Enterococcus in the health care setting. J Clin Microbiol. 2016 Oct;54(10):2436-47. [PubMed] [Crossref]-
4. Brown DFJ, Walpole E. Evaluation of selective and enrichment media for isolation of glycopeptide-resistant enterococci from faecal specimens. J Antimicrob Chemother. 2003 Feb;51(2):289-96. [PubMed]
5. Gordts B, Van Landuyt H, Ieven M, Vandamme P, Goossens H. Vancomycin-resistant enterococci colonizing the intestinal tracts of hospitalized patients. J Clin Microbiol. 1995 Nov;33(11):2842-6. [PubMed]
6. Kallstrom G, Doern CD, Dunne MW. Evaluation of a chromogenic agar under development to screen for VRE colonization. J Clin Microbiol. 2010 Mar;48(3):999-1001. [PubMed]
7.Suwantarat N, Roberts A, Prestridgem J, Seeleym R, Speser S, Harmon C, et al. Comparison of five chromogenic media for recovery of vancomycin-resistant enterococci from fecalsamples. J Clin Microbiol. 2014 Nov;52(11):4039-42. [PubMed] [Crossref]
8.Popova V, Sredkova M, Hitkova H, Todorov V, Borisov B, Dimitrova B. Fecal colonization with vancomycin-resistant enterococci in haemodialysis patients. XI National Congress on Clinical Microbiology and Infections, Sofia, 9-11.05.2013; p.23.
9. Christensen J, Ruoff K. Aerococcus, Abiotrophia, and other aerobic catalase-negative Gram-positive cocci. In: Manual of clinical microbiology. Jorgensen JH, Pfaller MA, Carroll KC, eds. 11th edition. Washington, DC: ASM Press. 2015. pp. 422-436.
10. Teixeira ML, Carvalho SM, Facklam R, Shewmaker LP. Enterococcus. In: Manual of clinical microbiology. Jorgensen JH, Pfaller MA, Carroll KC, eds. 11th edition. Washington, DC: ASM Press. 2015. pp. 403-421.
11. Ramotar K, Woods W, Larocque L, Toye B. Comparison of phenotypic methods to identify enterococci intrinsically resistant to vancomycin (vanC VRE). Diagn< Microbiol Infect Dis. 2000 Feb;36(2):119-24. [PubMed]
12. Abele-Horn M, Hommers L, Trabold R, Frosch M. Validation of VITEK 2 version 4.01 software for detection,identification, and classification of glycopeptide-resistant enterococci. J Clin Microbiol. 2006 Jan;44(1):71-76. [PubMed]
13. Fang H, Ohlsson AK, Ullberg M, Ozenci V. Evaluation of species-specific PCR, Bruker MS, VITEK MS and the VITEK 2 system for the identification of clinical Enterococcus isolates. Eur J Clin Microbiol Infect Dis. 2012 Nov;31(11):3073-7. [PubMed]
14. Almuzara M, Barberis C, Velazquez VR, Ramirez MS, Famiglietti A, Vay C. Matrix-assisted Laser Desorption Ionization-Time-of-Flight Mass Spectrometry (MALDI-TOF MS) as a Reliable Tool to Identify Species of Catalase-negative Gram-positive Cocci not Belonging to the Streptococcus Genus. Open Microbiol J. 2016 Dec 28;10:202-208. [PubMed] [Crossref]
15. Winston L.G, Pang S, Haller BL, Wong M, Chambers HF 3rd, Perdreau-Remington F. API 20 strep identification system may incorrectly speciate enterococci with low level resistanceto vancomycin. DiagnMicrobiolInfectDis. 2004 Apr;48(4):287-8. [PubMed]
16. Kulwichit W, Nilgate S, Chatsuwan T, Krajiw S, Unhasuta C, Chongthaleong A. Accuracies of Leuconostoc phenotypic identification: a comparison of API systems and conventionalphenotypic assays. BMC Infect Dis. 2007;7:69-77.
17. Quiloan MLG, Vu J, Carvalho J. Enterococcus faecalis can be distinguished from Enterococcus faecium via differential susceptibility to antibiotics and growth and fermentation characteristics on mannitol salt agar. Front Biol. 2012 Apr;7(2):167-177. [Crossref]
18. Swenson JM, Facklam RR, Thornsberry C. Antimicrobial susceptibility of vancomycin-resistant Leuconostoc, Pediococcus, and Lactobacillus species. J Antimicrob Chemother. 1990;34(4):543-549.
19. Popova V, Hitkova H, Ivanov I, Sredkova M, Biseva L, Edreva V, et al. Emergence of vancomycin-resistant enterococci in University Hospital-Pleven. XII National Congress on Clinical Microbiology and Infections, Sofia. 24-26.04.2014; p.19.
20. Ivanov IN, Dobrinov V, Hitkova H, Popova V, Ivanova K, Dobreva E, et al. Molecular characterization of a large hospital outbreak caused by glycopeptide-resistant Enterococcus faecium ST203(CC17). 28th ECCMID, Madrid, Spain, 21-24.04.2018, PO 460.

Received: 30 November 2018
Published online: 05 August 2019

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