Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2018, vol. 27, nr 1, January, p. 111–117

doi: 10.17219/acem/68265

Publication type: original article

Language: English

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Typing of Enterococcus spp. strains in 4 hospitals in the Małopolska region in Poland

Katarzyna Talaga1,A,B,C,D,E,F, Dalma Odrowąż-Konduracka2,B,F, Beata Paradowska3,B,F, Barbara Jagiencarz-Starzec4,B,F, Zdzisław Wolak4,B,F, Małgorzata Bulanda5,E,F, Anna Szczypta6,B,C,E,F

1 Department of Mycology, Chair of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland

2 The Gabriel Narutowicz Municipal Specialistic Hospital, Kraków, Poland

3 The John Paul II Hospital, Kraków, Poland

4 St. Luke Provincial Hospital, Tarnów, Poland

5 Department of Epidemiology of Infections, Chair of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland

6 Department of Health and Medical Sciences, Andrzej Frycz Modrzewski Krakow University, Poland

Abstract

Background. In the Małopolska province, the first case of vancomycin resistant enterococci (VRE) occurrence was an outbreak in 2001 caused by strains of the genus E. faecium carrying the vanA operon.
Objectives. The aim of this study is to determine the antimicrobial resistance and the occurrence of virulence determinants among Enterococcus spp. in patients hospitalized in the Małopolska region in 2015.
Material and Methods. Antimicrobial susceptibility was determined by disc diffusion and the E test. The presence of aminoglycoside and glycopeptide resistance genes and virulence genes (asa1, gelE, cylA, esp, hyl) was investigated using multiplex polymerase chain reaction (PCR). Also, the presence of IS16 was investigated. The activity of gelatinase, cytolysin (hemolysin), and DNase was tested.
Results. All E. faecalis were susceptible to ampicillin, vancomycin, teicoplanin, linezolid and tigecycline. All E. faecium strains were susceptible to quinupristin-dalfopristin. Resistance to ampicillin and vancomycin was detected among all E. faecium isolates from hospitals C and D. 87.32% of E. faecium presented high-level aminoglycoside-resistant (HLAR) phenotype, including 78.33% of strains from hospital C and 100% from hospital D. In hospital C (98.3%) and D (96%), resistance to ciprofloxacin, levofloxacin and norfloxacin was observed. Gene esp was detected in all E. faecium isolates and the majority of E. faecium isolates carried hyl (97%). In E. faecalis, different combinations of virulence genes were detected. All analyzed E. faecium strains showed the presence of IS16 insertion element.
Conclusion. E. faecalis isolates were more susceptible to antimicrobials than E. faecium, which were largely multidrug-resistant. E. faecalis strains have diverse virulence factors. E. faecium showed a high percentage of hyl and esp genes and the presence of IS16.

Key words

virulence factors, healthcare-associated infections, Enterococcus, vancomycin resistant enterococci (VRE), antimicrobial susceptibility

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