Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2008, vol. 17, nr 3, May-June, p. 259–268

Publication type: original article

Language: English

Frequency and Antibiotic Susceptibility of Enterococcal Strains Isolated from Patients of Different Departments of a University Teaching Hospital in Wrocław

Częstość izolacji i lekowrażliwość szczepów z rodzaju Enterococcus pochodzących od pacjentów hospitalizowanych w klinikach Akademickiego Szpitala Klinicznego we Wrocławiu

Beata Kowalska−Krochmal1,, Izabela Dolna1,, Krzysztof Szufnarowski2,, Ewa Dworniczek1,, Roman Franiczek1,, Hanna Daszkowska3,, Grażyna Gościniak1,, Irena Choroszy−Król1,

1 Department and Unit of Microbiology, Silesian Piasts University of Medicine in Wrocław, Poland

2 University Teaching Hospital, Hospital Infections Group, Wrocław, Poland

3 Microbiology Laboratory of the University Laboratory Diagnostic, Wrocław, Poland

Abstract

Background. Strains of Enterococcus have in recent years become one of the most frequent etiology factors in nosocomial infections, both in children and adults. The biggest threat are the strains resistant to glycopeptide and to high level aminoglycosides
Objectives. Estimation of frequency of isolation and drug susceptibility of enterococci obtained from differen clinical samples from patients from University Teaching Hospital (UTH) in Wrocław.
Material and Methods. One thousand nine hundred thirty three (1933) strains of Enterococcus isolated from patients from different clinic of UTH were enrolled in this study. Frequency of isolation of enteroccocci in relation to general number of strains (N = 12435) and in relation to Gram−positive bacteria (5581) collected in period 1.01.2006–28.02.2007 was determined. Susceptibility to ampicillin, doxycycline, ciprofloxacin, gentamicin, vancomycin and teicoplanin was estimated.
Results. More than 2/3 of enterococci were isolated in pediatric wards. Highest number of strains was isolated from children from the Department of Bone Marrow Transplantation (23.6%), from Pediatric and Gastroenterology Hospital (20.6) and from adults from Gastroenterology Hospital (11.4%). Most frequently enterococci were obtained from stool and urine. Twenty strains were isolated from blood, 5 from cerebrospinal fluid and 11 strains from other physiological sterile fluids. Fiftheen strains were resistant to vancomicin, all of which belonged to the species E. faecium and were obtained from nephrology department patients (1 child and 14 adults). The percentage of HLGR strains reached 23,6% in the E. faecalis group and 40.3% in E. faecium group. E. faecalis strains were more susceptible to to ampicillin (97,3% i 3,4% respectively) and less susceptible to doxycycline (28.0% i 67.6% respectively).
Conclusion. Isolation of VRE strains from Nefrological Departments suggest necessity monitoring of glycopeptide susceptibility among strains obtained as from urine as other clinical samples especially from stool (VRE colonization).

Streszczenie

Wprowadzenie. Szczepy z rodzaju Enterococcus w ostatnich latach stały się jednym z najczęstszych czynników etiologicznych zakażeń szpitalnych, zarówno u dzieci, jak i dorosłych. Największym zagrożeniem stają się szczepy oporne na glikopeptydy oraz duże stężenia aminoglikozydów.
Cel pracy. Ocena częstości izolacji i lekowrażliwości enterokoków pochodzących z różnych próbek klinicznych od pacjentów z klinik Akademickiego Szpitala Klinicznego (ASK) we Wrocławiu.
Materiał i metody. Analizie poddano 1933 szczepy z rodzaju Enterococcus wyizolowane od pacjentów z różnych klinik ASK. Oceniono częstość izolacji enterokoków zarówno w odniesieniu do ogólnej puli szczepów (12435), jak i do Gram−dodatnich bakterii (5581) wyosobnionych od pacjentów w okresie od 1.01.2006 do 28.02.2007 r. Oceniono wrażliwość na ampicylinę, doksycyklinę, ciprofloksacynę, gentamycynę, wankomycynę i teikoplaninę.
Wyniki. Ponad 2/3 enterokoków pochodziło z oddziałów pediatrycznych. Najwięcej szczepów wyizolowano z Oddziału Przeszczepów Szpiku (23,4%) i z Kliniki Pediatrii i Gastroenterologii (20,6%) oraz od dorosłych z Kliniki Gastroenterologii (11,4%). Enterokoki były najczęściej wyosobniane z kału i moczu. Dwadzieścia wyizolowano z krwi, 5 z płynu mózgowo−rdzeniowego i 11 z innych fizjologicznie jałowych płynów. Piętnaście szczepów było opornych na wankomycynę, wszystkie należały do gatunku E. faecium, wyizolowanych od 14 dorosłych i 1 dziecka z oddziałów nefrologicznych. Odsetek szczepów HLGR wynosił 23,6% wśród E. faecalis i 40,3% wśród E. faecium. Szczepy E. faecalis były bardziej niż E. faecium wrażliwe na ampicylinę (odpowiednio 97,3 i 3,4%) i ciprofloksacynę (49,5 i 11,3%), a mniej wrażliwe na doksycyklinę (odpowiednio 28,0 i 67,6%).
Wnioski. Izolacja szczepów bakterii z rodzaju Enterococcus opornych na wankomycynę VRE z oddziałów nefrologii sugeruje konieczność stałego monitorowania wrażliwości na glikopeptydy zarówno enterokoków izolowanych z moczu, jak i z innych materiałów, zwłaszcza z kału (kolonizacja szczepami VRE).

Key words

Enterococcus, frequency of isolation, antibiotic susceptibility

Słowa kluczowe

Enterococcus, częstość izolacji, antybiotykowrażliwość

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