Multidrug-resistant enterococci in the hospital environment: Detection of novel vancomycin-resistant E. faecium clone ST910

  1. Dziri, R. 2
  2. Lozano, C. 1
  3. Ben Said, L. 2
  4. Bellaaj, R. 3
  5. Boudabous, A. 2
  6. Ben Slama, K. 22
  7. Torres, C. 1
  8. Klibi, N. 2
  1. 1 Universidad de La Rioja
    info

    Universidad de La Rioja

    Logroño, España

    ROR https://ror.org/0553yr311

  2. 2 Université de Tunis El Manar
    info

    Université de Tunis El Manar

    Túnez, Túnez

    ROR https://ror.org/029cgt552

  3. 3 Military Hospital of Tunis
    info

    Military Hospital of Tunis

    Túnez, Túnez

    ROR https://ror.org/04n4f3r80

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Revista:
Journal of Infection in Developing Countries

ISSN: 2036-6590

Año de publicación: 2016

Volumen: 10

Número: 8

Páginas: 799-806

Tipo: Artículo

DOI: 10.3855/JIDC.8014 SCOPUS: 2-s2.0-84985019780 WoS: WOS:000388365600004 GOOGLE SCHOLAR

Otras publicaciones en: Journal of Infection in Developing Countries

Repositorio institucional: lock_openAcceso abierto Editor

Resumen

Introduction: The role of the hospital environment as a reservoir of resistant bacteria in Tunisia has been poorly investigated; however, it could be responsible for the transmission of multidrug-resistant bacteria. The objective was to study the prevalence of Enterococcus in the environment of a Tunisian hospital and the antibiotic resistance phenotype/genotype in recovered isolates, with special reference to vancomycin resistance. Methodology: A total of 300 samples were taken (March–June, 2013) and inoculated in Slanetz-Bartley agar plates supplemented or not supplemented with 8 µg/mL of vancomycin. Antibiotic resistance genes were tested by polymerase chain reaction (PCR). The clonal relatedness of the vanA isolates was assessed using pulsed-field gel electrophoresis (PFGE) and multilocus sequence testing (MLST). Results: Enterococci were recovered in 33.3% of tested samples inoculated in SB medium. E faecium was the most prevalent species, followed by E. faecalis and E. casseliflavus. Antimicrobial resistance genes detected were as follows (number of isolates): erm(B) (71), tet(M) (18), aph(3’)-IIIa (27), ant(6)-Ia (15), cat(A) (4), and van(C2) (6). Vancomycin-resistant-enterococci (VRE) were recovered from 14 samples (4.7%), when tested in SB-VAN. The 14 VRE (one per positive sample) were identified as E. faecium and contained the van(A),erm(B), tet(M), ant(6)-Ia, and aph(3’)-IIIa genes. Thirteen of the VRE strains were ascribed by PFGE and MLST to a novel clone (new ST910), and only one VRE strain was typed as ST80 included in CC17. Conclusions: The emergence and spread of new clones of VRE, especially in the hospital environment in this country, could become particularly problematic. © 2016 Dziri et al.