Abstract
Background. Enterococcus spp. are opportunistic agents of community-acquired and in-hospital infections, which have been considered a threat to public health due to their antimicrobial resistance, primarily to glycopeptides, in recent years.The aim of the study is to determine the prevalence of various Enterococcus species causing infections in hospitalized patients and their antimicrobial resistance.Methods included identification by MALDI-TOF mass spectrometry and antimicrobial susceptibility testing in accordance with the EUCAST or, in their absence, CLSI guidelines.Results. Antimicrobial resistance in 1562 consecutive Enterococcus strains isolated from hospitalized patients was determined in a major medical center admitting patients from various regions of the Russian Federation in 2019. The predominance of E.faecalis and E.faecium (99.5%) was revealed; the frequency of isolation of the former was 56% higher than that of the latter. E.avium, E.casseliflavus, E.gallinarum, E.durans were isolated from 0.5% of biological samples. The highest level of resistance of enterococci was observed to erythromycin (84.8%), tetracycline (75.0%), and rifampicin (68.2%). Multidrug, as well as vancomycin resistance, prevailed in E.faecium. All E.faecium strains isolated from blood were multidrug resistant. Resistance to vancomycin in enterococci, causing bloodstream infections, was observed solely in 19.5% of E.faecium; all vancomycin-resistant isolates were also resistant to teicoplanin. Linezolid resistance was detected in 2 community-acquired strains of E.faecalis (0.1%). Rare enterococci have shown diverse patterns of antimicrobial resistance.Conclusions. E.faecalis and E.faecium prevailed among Enterococcus spp. causing infections in hospitalized patients. Multidrug resistance and vancomycin resistance were observed predominantly in E.faecium, especially in strains causing blood-stream infections. Further monitoring of the spread and antimicrobial resistance of various Enterococcus spp. in hospital and community-acquired infections is needed.
Highlights
Enterococcus spp. are opportunistic agents of community-acquired and in-hospital infections, which have been considered a threat to public health due to their antimicrobial resistance, primarily to glycopeptides, in recent years
All E.faecium strains isolated from blood were multidrug resistant
Resistance to vancomycin in enterococci, causing bloodstream infections, was observed solely in 19.5% of E.faecium; all vancomycin-resistant isolates were resistant to teicoplanin
Summary
Определение распространенности различных видов энтерококков — возбудителей инфекций у госпитализированных пациентов и их резистентности к антибактериальным препаратам. Мультирезистентность и резистентность к ванкомицинy были характерны преимущественно для E.faecium. Устойчивость к ванкомицину у энтерококков, обусловивших развитие инфекций кровотока, наблюдали исключительно у 19,5% E.faecium, все ванкомицинорезистентные изоляты были устойчивы к тейкопланину. Резистентность к линезолиду выявили у 2 внебольничных штаммов E.faecalis (0,1%). Редкие виды энтерококков демонстрировали разнообразные паттерны антимикробной резистентности. Среди энтерококков — возбудителей инфекций у госпитализированных пациентов превалируют виды E.faecalis и E.faecium. Мультирезистентность и устойчивость к ванкомицину характерны преимущественно для E.faecium, особенно для штаммов — возбудителей инфекций кровотока. Необходимо проведение дальнейшего мониторинга распространения различных видов энтерококков в госпитальных и внебольничных условиях с определением их видовой принадлежности и антимикробной резистентности валидными методами. Ключевые слова: Enterococcus faecalis; E.faecium; Е.аvium; Е.casseliflavus; E.gallinarum; E.durans; резистентность.
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