Enterococcus raffinosus, Enterococcus durans and Enterococcus avium Isolated from a Tertiary Care Hospital in Romania-Retrospective Study and Brief Review.

Abstract

Simple SummaryEnterococcus faecium and Enterococcus faecalis are the most common species of Enterococcus spp. genus involved in human pathology. They are known for their increasing resistance to vancomycin, an antibiotic that blocks synthesis of Gram-positive bacteria’s cell wall. Other species of Enterococcus spp. (E. casseliflavus, E. gallinarum, E. durans, E. avium, E. raffinosus) are less common in human infections, and thus, their importance in the medical field is still uncertain. In this study, we analyzed the non-faecalis non-faecium Enterococci strains isolated from a tertiary care hospital in Romania for one year. Among a total of 658 Enterococcus isolates, 58 strains proved to be non-faecalis non-faecium Enterococci and met the inclusion criteria of our study. These species were isolated more frequently from mixed etiology infections with E. coli from the surgical ward. To put our results into perspective, a brief review of literature was performed in which we used 39 case reports involving non-faecalis non-faecium Enterococci. The emerging numbers of non-faecalis non-faecium Enterococci infections pose a danger to human health systems, due to their ability to easily acquire antibiotic resistance genes. To our knowledge, this study represents the first non-faecalis non-faecium Enterococci group analysis from Eastern Europe.(1) Background: This paper aims to provide a description of non-faecalis non-faecium enterococci isolated from a tertiary care hospital in Romania and to briefly review the existing literature regarding the involvement of Enterococcus raffinosus, Enterococcus durans and Enterococcus avium in human infections and their antimicrobial resistance patterns; (2) Methods: We retrospectively analyzed all Enteroccocus species isolated from the “Prof. Dr. O. Fodor” Regional Institute of Gastroenterology and Hepatology from Cluj-Napoca during one year focusing on non-faecalis non-faecium Enterococci. A brief review of the literature was performed using case reports involving Enterococcus raffinosus, Enterococcus durans and Enterococcus avium; (3) Results: Only 58 out of 658 Enteroccocus isolates were non-faecalis non-faecium and met the inclusion criteria. These species were isolated more often (p < 0.05) from the surgical ward from mixed etiology infections with E. coli. In our review, we included 39 case reports involving E. raffinosus, E. durans and E. avium; (4) Conclusions: Isolation of non-faecalis non-faecium enterococci displays an emerging trend with crucial healthcare consequences. Based on the analysis of the case reports, E. avium seems to be involved more often in neurological infections, E. durans in endocarditis, while E. raffinosus displays a more heterogenous distribution.