Molecular characterization of vancomycin-resistant enterococcus faecium isolates from patients admitted to the intensive care unit of Hatay State Hospital

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Date

2019

Journal Title

Journal ISSN

Volume Title

Publisher

Türk Yoğun Bakım Derneği

Access Rights

info:eu-repo/semantics/openAccess

Abstract

Objective: In this study, it was aimed to determine vancomycin resistance mechanisms, virulence genes and clonal relationships of 23 vancomycin-resistant Enterococcus faecium (VREfae) strains isolated from patients admitted to intensive care unit of Hatay State Hospital. Materials and Methods: Minimal inhibitor concentration (MIC) values of vancomycin were determined by E-test and antimicrobial susceptibility of the strains was determined by disc diffusion method. The clonal relationship among VREfae isolates was determined by pulsed-field gel electrophoresis (PFGE). Additionally, vancomycin resistance (vanA, vanB, vanC, vanD, vanE and vanG) and virulence genes (asa1, esp, gelE, hyl and cylA) were investigated by polymerase chain reaction (PCR) method. Results: All isolates harbored vanA gene and 17 isolates (73.9%) were positive for at least one virulence gene. The most common virulence gene was esp, which was detected in nine isolates alone and in two isolates together with hly gene. The hly gene was detected in five isolates alone and the other virulence genes (asa1, gelE and cylA) were not observed in any isolates tested. All isolates showed multidrug resistance phenotype. Vancomycin MIC values of the isolates were found to be ≥256 µg/mL by E-test. PFGE analysis revealed 14 different pulsotypes in five clusters (A, B, C, D and E). The presence of identical PFGE patterns indicated that there was a crosstransmission at hospital settings. Conclusion: Continuous surveillance of resistance patterns and molecular characteristics of VRE are needed to reduce the prevalence of infections caused by VRE and to take effective control measures in hospitals
Amaç: Bu çalışmada, Hatay Devlet Hastanesi yoğun bakım ünitesine başvuran hastalardan izole edilen 23 vankomisine dirençli Enterococcus faecium (VREfae) suşunun vankomisine olan direnç mekanizmalarının, virülans genlerinin ve klonal ilişkilerinin belirlenmesi amaçlandı. Gereç ve Yöntem: İzolatların vankomisin minimal inhibitör konsantrasyon (MİK) değerleri E-testi ile antimikrobiyallere olan duyarlılıkları ise disk difüzyon yöntemi ile saptandı. VREfae izolatları arasında klonal ilişki pulsed-field jel elektroforezi (PFGE) ile belirlendi. Vankomisin direnç (vanA, vanB, vanC, vanD, vanE ve vanG) ve virülans genleri (asa1, esp, gelE, hyl ve cylA) polimeraz zincir reaksiyonu (PZR) yöntemi ile araştırıldı. Bulgular: Bütün izolatlar vanA geni taşıdığı tespit edildi ve izolatların 17’si (%73,9) en az bir virülans geni yönünden pozitif bulundu. En yaygın virülans geni olan esp, dokuz izolatta tek başına ve iki izolatta ise hly geni ile birlikte saptandı. hly geni tek başına beş izolatta tespit edilirken ve incelenen diğer virülans genleri (asa1, gelE ve cylA) ise hiçbir izolatta tespit edilmedi. İzolatların tamamı çoğul direnç fenotipi gösterdi. İzolatların vankomisin MİK değerleri E-test ile ≥256 µg/mL olarak bulundu.

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Keywords

Vancomycin-resistant Enterococcus faecium, Pulsed-field gel electrophoresis, Virulence genes, Vankomisine dirençli Enterococcus faecium, Pulsed-field jel elektroforezi, Virülens genleri

Journal or Series

Türk Yoğun Bakım Dergisi

WoS Q Value

N/A

Scopus Q Value

Volume

17

Issue

4

Citation

Sakin, F., Aslantaş, Ö., & Bağcı, F. (2019). Molecular Characterization of Vancomycin-Resistant Enterococcus faecium Isolates from Patients Admitted to the Intensive Care Unit of Hatay State Hospital. Türk Yogun Bakim Dergisi, 17(4), 204.