JOMPAC
Journal of Medicine and Palliative Care

Journal of Medicine and Palliative Care (JOMPAC) is an open access scientific journal with independent, unbiased, and double-blind review under international guidelines. The purpose of JOMPAC is to contribute to the literature by publishing articles on health sciences and medicine.

eISSN: 2717-7505
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Submit Manuscript

Index
Original Article
Evaluation of antibiotic susceptibility in enterococci isolated from blood culture samples
Abstract
Aims: Increased vancomycin resistance in enterococci is an important cause of life-threatening bloodstream infections in hospitalized patients. The aim of this study is to determine the antibiotic susceptibility rates of Enterococcus strains isolated from blood cultures in hospitalized patients.
Methods: The antibiotic resistance rates of Enterococcus strains isolated from blood cultures of patients hospitalized in the service and intensive care units (ICU) between 1 January 2018 and 30 December 2022 were examined retrospectively. Blood samples were studied with the BacT/ALERT 3D culture system (Biomerieux, France). Bacterial identification was performed using conventional methods, Matrix Assisted Laser Desorption-Ionization Time-of-Flight Mass Spectrometer (MALDI-TOF MS) and VITEK 2 (Biomerieux, France) systems. Antimicrobial susceptibility tests were performed with VITEK 2 (Biomerieux, France) systems. Ampicillin, vancomycin, teicoplanin, high-level gentamicin resistance (HLGR) and linezolid susceptibility of isolated strains were evaluated according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria. Vancomycin minimal inhibitory concentration (MIC) values of vancomycin resistant strains were studied by microdilution gradient strip test (Bioanalyse).
Results: A total of 623 strains of enterococci were isolated from blood culture samples. Of the enterococci, 305 (48.9%) were identified as Enterococcus faecalis, 281 (45.6%) Enterococcus faecium, 12 (1.9%) Enterococcus avium, 11 (1.8%) Enterococcus gallinarum, 7 (1.2%) Enterococcus casseliflavus, 2 (0.4%) Enterococcus durans and 1 Enterococcus hirae (0.2%). Ampicillin and HLGR resistance rates of isolated E. faecalis strains were 11 (3.6%) and 72 (23.6%), respectively, and all strains were found to be susceptible to vancomycin, teicoplanin and linezolid. The ampicillin, vancomycin, teicoplanin and HLGR resistance rates of E. faecium strains were determined as 229 (81.5%), 36 (12.8%), 30 (10.7%) and 142 (50.5%), respectively, and all strains were found to be susceptible to linezolid.
Conclusion: In infections caused by enterococci, identification and determination of antibiotic susceptibility rates according to culture antibiogram results would be the right approach. Knowing the current susceptibility rates of enterococci isolated from blood culture samples in our hospital will contribute for clinicians’ planning of empirical treatment.

Keywords : Enterococci, blood culture, antibiotic susceptibilities

Download Article


1. Sava IG, Heikens E, Huebner J. Pathogenesis and immunity inenterococcal infections. Clin Microbiol Infect. 2010;(16):533-540.
2. Markwart R, Willrich N, Haller S, et al. The rise in vancomycin-resistant Enterococcus faecium in Germany: data fromthe German Antimicrobial Resistance Surveillance (ARS).Antimicrob Resist Infect Control. 2019;8:147.
3. Gök ŞM, Türk Dağı H, Kara F, Arslan U, Fındık D. Klinikörneklerden izole edilen Enterococcus faecium ve Enterococcusfaecalis izolatlarının antibiyotik direnci ve virülans faktörlerininaraştırılması. Mikrobiyol Bul. 2020;54(1):26-39.
4. Tripathi A, Shukla S, Singh A, Prasad K. Prevalence, outcome andrisk factor associated with vancomycin-resistant Enterococcusfaecalis and Enterococcus faecium at a tertiary care hospital inNorthern India. Indian J Med Microbiol. 2016;34(1):38-45.
5. Türk Dağı H, Arslan U, Tuncer Eİ. Kan kültürlerinden izoleedilen enterokoklarda antibiyotik direnci. Türk Mikrobiyol CemDerg. 2011;41(3):103-106.
6. Çelik C, Taşkın-Kafa AH, Hasbek M, Büyüktuna SA.Antimicrobial resistance in Enterococcus faecalis andEnterococcus faecium bacteria ısolated from bloodstreamınfections: A single-center evaluation. Klimik J. 2021;34(1):37-41.
7. Boccella M, Santella B, Pagliano P, et al. Prevalence andantimicrobial resistance of Enterococcus species: a retrospectivecohort study in Italy. Antibiotics. 2021;10(12):1552.
8. Mogokotleng R, Ismail H, Perovic O, Jallow S. A retrospectiveanalysis of culture-confirmed Enterococci bloodstream ınfectionsin South Africa, 2016-2020: a cross-sectional study. Trop MedInfect Dis. 2022;8(1). doi: 10.3390/tropicalmed8010019.
9. Miller WR, Munita JM, Arias CA. Mechanisms of antibioticresistance in enterococci. Expert Rev Anti Infect Ther.2014;12(10):1221-1236.
10. Gagetti P, Bonofiglio L, García Gabarrot G, et al. Resistance toβ-lactams in enterococci. Rev Argent Microbiol. 2019;51(2):179-183.
11. Schöneweck F, Schmitz RPH, Rißner F, et al. The epidemiologyof bloodstream infections and antimicrobial susceptibilitypatterns in Thuringia, Germany: a five-year prospective, state-wide surveillance study. Antimicrob Resist Infect Control.2021;10(1):132.
12. Şanlı K. Yoğun bakım ünitesindeki erişkin hastaların kankültüründe üretilen Enterococcus faecalis ve Enterococcusfaecium’un prevalansı ve antimikrobiyal duyarlılıkları. IKSSTD.Published online 2022. doi:10.14744/iksstd.2022.55823
13. Jabbari Shiadeh SM, Pormohammad A, Hashemi A, Lak P. Globalprevalence of antibiotic resistance in blood-isolated Enterococcusfaecalis and Enterococcus faecium: a systematic review and meta-analysis. Infect Drug Resist. 2019;12:2713-25.
14. O’Driscoll T, Crank CW. Vancomycin-resistant enterococcalinfections: epidemiology, clinical manifestations, and optimalmanagement. Infect Drug Resist. 2015;8:217-30.
15. Vural T, Şekercioğlu AO, Dilara Ö, Meral G, Dilek Ç, Akın Y.Vankomisine dirençli Enterococcus casseliflavus suşu. 13 AnkemDerg. 1998;12(2):113.
16. Khan A, Miller WR, Axell-House D, Munita JM, Arias CA.Antimicrobial susceptibility testing for Enterococci. J ClinMicrobiol. 2022;60(9):e0084321.
17. Arundathi HA, Prakash N, Halesh HL, Siddesh KC. Prevalenceof high level gentamicin resistance among the clinical ısolates ofEnterococci species. J Pure Appl Microbiol. 2022;16(2):1004-1009.
18. Alkan Ceviker S, Gunal O, Koksal E, Aygun C, Kilic SS.Comparison of health care-associated Enterococcus faecium andEnterococcus faecalis bloodstream ınfections. Klimik Dergisi/Klimik J. 2020;33(1):87-90.
19. Durmaz S, Ozer T. Antibiotic susceptibilities of Enterococciısolated from blood cultures. Ulutas Med J. 2015;1(4):111.
20. Aktaş G, Bozdoğan B, Derbentli S. In vitro activity of linezolidand dalbavancin against vancomycin-resistant enterococci.Mikrobiyol Bul. 2012;46(3):359-365.
Article available in :
Volume 4, Issue 5, 2023
Page : 385-388
https://doi.org/10.47582/jompac.1340041
Article Information
Received : 09 Ağu 2023
Accepted : 02 Eyl 2023
Published : 27 Eki 2023
Corresponding Author :

Özlem Koca: Department of Medical Microbiology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey

[email protected]
Citation : Koca Ö, Er H, Çekin Y. Evaluation of antibiotic susceptibility in enterococci isolated from blood culture samples. J Med Palliat Care. 2023;4(5):385-388.

Read: 70
Cited: 0
Download : 78
_Footer