Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1 (5-Year IF – 2.0)
Journal Citation Indicator (JCI) (2023) – 0.4
Scopus CiteScore – 3.7 (CiteScore Tracker 3.8)
Index Copernicus  – 171.00; MNiSW – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2015, vol. 24, nr 1, January-February, p. 121–127

doi: 10.17219/acem/38162

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Genotypic Variations of Virulent Genes in Enterococcus faecium and Enterococcus faecalis Isolated from Three Hospitals in Malaysia

Hassanain Al-Talib1,C,D,E, Nik Zuraina2,A,B,C, Balqis Kamarudin2,A,B,C, Chan Y. Yean2,A,E,F

1 Laboratory Medical Science Cluster, Drug Discovery & Health Community of Research, Faculty of Medicine, MARA University of Technology (UiTM), Sungai Buloh, Selangor Darul Ehsan, Malaysia

2 Department of Medical Microbiology and Parasitology, School of Medical Sciences, University Sains Malaysia, Kota Bharu, Malaysia

Abstract

Background. The genus Enterococcus is of increasing significance as a cause of nosocomial infections, and this trend is exacerbated by the development of antibiotic resistance.
Objectives. The aim of the present study was to estimate the potential virulence factors in enterococci and to ascertain their prevalence in Malaysian hospitals.
Material and Methods. The study comprised 222 enterococcal strains isolated from blood, urine, exudates, sputum, stool and body fluid. These strains were collected from patients staying in three referral hospitals in Malaysia. All isolates were identified to the species level, and their MIC of vancomycin was determined using E test strips. Specific primers were designed for detection of the five potential virulence genes (gelE, PAI, esp, ace, and sprE) by PCR assay.
Results. Different patterns and frequency of virulence determinants were found for the E. faecalis and E. faecium isolates. E. faecalis isolates had more virulence determinants than E. faecium isolates. Clinical enterococcal isolates were found to possess more virulence determinants than enterococci isolated from faecal samples. The esp gene is significantly more common (p = 0.049) in vancomycin-resistant strains (85.7%) than in vancomycin-sensitive strains (44.2%). All of the vancomycin-resistant isolates were isolated from faecal samples. None of the classical virulence factors were found in 11% of enterococcal isolates, while all five virulence genes were found in 21% of enterococcal isolates.
Conclusion. All the virulence genes considered in this study were important in the pathogenesis of enterococcal infections and further studies including more virulence genes and epidemiological data will be necessary in order to analyze the association and role of virulence genes in the pathogencity of enterococci .

Key words

Enterococcus, virulent genes, gelE, PAI, esp, ace, and sprE,PCR.

References (23)

  1. Kayaoglu G, Orstavik D: Virulence factors of Enterococcus faecalis: relationship to endodontic disease. Crit Rev Oral Biol Med 2004, 15, 308–320.
  2. Jett BD, Huycke MM, Gilmore MS: Virulence of enterococci. Clin Microbiol Rev 1994, 7, 462–478.
  3. Willems RJ, Homan W, Top J, van Santen-Verheuvel M, Tribe D, Manzioros X, Gaillard C, VandenbrouckeGrauls CM, Mascini EM, van Kregten E, van Embden JD, Bonten MJ: Variant esp gene as a marker of a distinct genetic lineage of vancomycin-resistant Enterococcus faecium spreading in hospitals. Lancet 2001, 357, 853–855.
  4. Moellering RC, Jr.: Emergence of Enterococcus as a significant pathogen. Clin Infect Dis 1992, 14, 1173–1176.
  5. Gutschik E, Moller S, Christensen N: Experimental endocarditis in rabbits. 3. Significance of the proteolytic capacity of the infecting strains of Streptococcus faecalis. Acta Pathol Microbiol Scand B 1979, 87, 353–362.
  6. Lopes Mde F, Simoes AP, Tenreiro R, Marques JJ, Crespo MT: Activity and expression of a virulence factor, gelatinase, in dairy enterococci. Int J Food Microbiol 2006, 112, 208–214.
  7. Hentschel U, Hacker J: Pathogenicity islands: the tip of the iceberg. Microbes Infect 2001, 3, 545–548.
  8. Leavis H, Top J, Shankar N, Borgen K, Bonten M, van Embden J, Willems RJ: A novel putative enterococcal pathogenicity island linked to the esp virulence gene of Enterococcus faecium and associated with epidemicity. J Bacteriol 2004, 186, 672–682.
  9. Heikens E, Bonten MJ, Willems RJ: Enterococcal surface protein Esp is important for biofilm formation of Enterococcus faecium E1162. J Bacteriol 2007, 189, 8233–8240.
  10. Van Wamel WJ, Hendrickx AP, Bonten MJ, Top J, Posthuma G, Willems RJ: Growth condition-dependent Esp expression by Enterococcus faecium affects initial adherence and biofilm formation. Infect Immun 2007, 75, 924–931.
  11. Lund B, Billstrom H, Edlund C: Increased conjugation frequencies in clinical Enterococcus faecium strains harbouring the enterococcal surface protein gene esp. Clin Microbiol Infect 2006, 12, 588–591.
  12. Vankerckhoven V, Van Autgaerden T, Vael C, Lammens C, Chapelle S, Rossi R, Jabes D, Goossens H: Development of a multiplex PCR for the detection of asa1, gelE, cylA, esp, and hyl genes in enterococci and survey for virulence determinants among European hospital isolates of Enterococcus faecium. J Clin Microbiol 2004, 42, 4473–4479.
  13. Woodford N, Soltani M, Hardy KJ: Frequency of esp in Enterococcus faecium isolates. Lancet 2001, 358, 584.
  14. Turenne CY, Hoban DJ, Karlowsky JA, Zhanel GG, Kabani AM: Screening of stool samples for identification of vancomycin-resistant Enterococcus isolates should include the methyl-alpha-D-glucopyranoside test to differentiate nonmotile Enterococcus gallinarum from E. faecium. J Clin Microbiol 1998, 36, 2333–2335.
  15. Al-Talib H, Yean CY, Al-Khateeb A, Hassan H, Singh KK, Al-Jashamy K, Ravichandran M: A pentaplex PCR assay for the rapid detection of methicillin-resistant Staphylococcus aureus and Panton-Valentine Leucocidin. BMC Microbiol 2009, 9, 113.
  16. http://wwwncbinlmnihgov/BLAST:
  17. Coque TM, Patterson JE, Steckelberg JM, Murray BE: Incidence of hemolysin, gelatinase, and aggregation substance among enterococci isolated from patients with endocarditis and other infections and from feces of hospitalized and community-based persons. J Infect Dis 1995, 171, 1223–1229.
  18. Cosentino S, Podda GS, Corda A, Fadda ME, Deplano M, Pisano MB: Molecular detection of virulence factors and antibiotic resistance pattern in clinical Enterococcus faecalis strains in Sardinia. J Prev Med Hyg 2010, 51, 31–36.
  19. Sharifi Y, Hasani A, Ghotaslou R, Naghili B, Aghazadeh M, Milani M, Bazmany A: Virulence and antimicrobial resistance in enterococci isolated from urinary tract infections. Adv Pharm Bull 2013, 3, 197–201.
  20. Eaton TJ, Gasson MJ: Molecular screening of Enterococcus virulence determinants and potential for genetic exchange between food and medical isolates. Appl Environ Microbiol 2001, 67, 1628–1635.
  21. Eaton TJ, Gasson MJ: A variant enterococcal surface protein Esp(fm) in Enterococcus faecium; distribution among food, commensal, medical, and environmental isolates. FEMS Microbiol Lett 2002, 216, 269–275.
  22. Shankar V, Baghdayan AS, Huycke MM, Lindahl G, Gilmore MS: Infection-derived Enterococcus faecalis strains are enriched in esp, a gene encoding a novel surface protein. Infect Immun 1999, 67, 193–200.
  23. Shankar N, Baghdayan AS, Gilmore MS: Modulation of virulence within a pathogenicity island in vancomycinresistant Enterococcus faecalis. Nature 2002, 417, 746–750.
© Wroclaw Medical University