Abstract
Enterococci are important bacterial pathogens, and their significance is even greater in the case of vancomycin-resistant enterococci (VRE). The study analyzed the presence of VRE in the gastrointestinal tract (GIT) of hemato-oncological patients. Active screening using selective agars yielded VRE for phenotypic and genotypic analyses. Isolated strains were identified with MALDI-TOF MS, (Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry) their susceptibility to antibiotics was tested, and resistance genes (vanA, vanB, vanC-1, vanC2-C3) and genes encoding virulence factors (asa1, gelE, cylA, esp, hyl) were detected. Pulsed-field gel electrophoresis was used to assess the relationship of the isolated strains. Over a period of three years, 103 VanA-type VRE were identified in 1405 hemato-oncological patients. The most frequently detected virulence factor was extracellular surface protein (84%), followed by hyaluronidase (40%). Unique restriction profiles were observed in 33% of strains; clonality was detected in 67% of isolates. The study found that 7% of hemato-oncological patients carried VRE in their GIT. In all cases, the species identified was Enterococcus faecium. No clone persisted for the entire 3-year study period. However, genetically different clusters were observed for shorter periods of time, no longer than eight months, with identical VRE spreading among patients.
Highlights
In today’s medicine, important bacterial pathogens are enterococci
They originated in the upper gastrointestinal tract (GIT), with pneumonia developing as a result of gastric content regurgitation and subsequent microaspiration [6]
Over a 3-year study period, stool samples and perianal swabs obtained from 1405 subjects were analyzed and a total of 103 vancomycin-resistant enterococci (VRE) were isolated, suggesting that 7.3% of hemato-oncological patients carried VRE in their GIT
Summary
In today’s medicine, important bacterial pathogens are enterococci. As etiological agents, they are responsible for community as well as healthcare-associated infections (HAIs), in patients with prolonged hospital stays, severe underlying disease, or previous broad-spectrum antibiotic therapy [1]. Sievert et al reported that enterococci belong to the most common bacterial pathogens causing HAIs in the USA [2]. Herkel et al found that enterococci accounted for 5% of all bacterial pathogens causing healthcare-associated pneumonia [5]. In these cases, they originated in the upper gastrointestinal tract (GIT), with pneumonia developing as a result of gastric content regurgitation and subsequent microaspiration [6]. Since approximately the 1970s, a vast majority of enterococcal HAIs have been caused by Enterococcus faecium and Enterococcus faecalis [7]
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