Abstract
BackgroundVancomycin-resistant Enterococcus spp. (VRE) have spread all over the world. The present study aims to investigate the species distribution, specimen type and susceptibilities of Enterococcal species collected from Nanjing Drum Tower Hospital from 2013 to 2018. Additionally, distribution of VRE and prevalence of van gene among VRE isolates were also analyzed.MethodsThe susceptibilities of 3913 Enterococcus isolates were retrospectively investigated. Among these strains, 60 VRE strains were further anazlyed in this study. The minimum inhibitory concentrations (MICs) of the VRE strains towards vancomycin, teicoplanin and linezolid were determined by E-test. Polymerase chain reaction (PCR) and DNA sequencing were used to investigate the prevalence of van genes among VRE. Furthermore, the sequence types (STs) of VRE strains were explored by multi-locus sequence typing (MLST).ResultsAmong the 3913 enterococci isolates, Enterococcus faecalis (n = 1870, 47.8%) and Enterococcus faecium (1738, 44.4%) were the main isolates. These Enterococcus strains were mainly isolated from urine (n = 1673, 42.8%), followed by secretions (n = 583, 14.9%) and ascites (n = 554, 14.2%). VRE displayed a decreasing trend year by year. Molecular analysis revealed that 49 out of 60 VRE isolates carried vanA gene, 10 carried vanM, and 1 carried both vanA and vanM genes. Sixteen distinct STs were identified among the 58 VREM, with ST78 (n = 16), ST192 (n = 8) and ST570 (n = 7) being the most dominant ones.ConclusionsE. faecalis and E. faecium were the major enterococci strains which are the main pathogens of urinary traction infections; vanA and vanM were the main determinants conferring resistance to vancomycin; ST78, ST192 and ST570 were the leading STs of VREM which displayed a decreasing trend of prevalence year by year.
Highlights
Vancomycin-resistant Enterococcus spp. (VRE) have spread all over the world
E. faecalis and E. faecium were the major enterococci strains which are the main pathogens of urinary traction infections; vanA and vanM were the main determinants conferring resistance to vancomycin; ST78, ST192 and ST570 were the leading sequence types (STs) of vancomycinresistant E. faecium (VREM) which displayed a decreasing trend of prevalence year by year
In Europe, an increasing proportion of vancomycinresistant E. faecium (VREM) has been reported [4], with the VREM being increased from 11.2% in 2014 to 26.1% in 2017 in German hospitals [5]; In Canadian hospitals, the national prevalence of VRE tripled from 1.8% in 2007 to 6.0% in 2013 and peaked at 7.9% in 2011 [6]; besides high cost of treatment of VRE, high mortality and additional morbidity caused by the frequent incidence of infections has been reported in US and European countries [1]
Summary
Vancomycin-resistant Enterococcus spp. (VRE) have spread all over the world. The present study aims to investigate the species distribution, specimen type and susceptibilities of Enterococcal species collected from Nanjing Drum Tower Hospital from 2013 to 2018. With the antimicrobial agents being frequently used in clinical treatment, antibiotic-resistant enterococci, multi-drug resistant enterococci isolates, such as vancomycin-resistant enterococci (VRE) and linezolidresistant enterococci (LRE) have emergence and spread all over the world [2, 3]. In Europe, an increasing proportion of vancomycinresistant E. faecium (VREM) has been reported [4], with the VREM being increased from 11.2% in 2014 to 26.1% in 2017 in German hospitals [5]; In Canadian hospitals, the national prevalence of VRE tripled from 1.8% in 2007 to 6.0% in 2013 and peaked at 7.9% in 2011 [6]; besides high cost of treatment of VRE, high mortality and additional morbidity caused by the frequent incidence of infections has been reported in US and European countries [1]. Infections of VRE have lead to increased cost and mortality compared to vancomycin-susceptible Enterococcus isolates [7]. Data on the characterization of VRE in tertiary hospitals in China are still limited
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