year 4, Issue 1 And 2 (9-2010)
Iran J Med Microbiol 2010, 4(1 And 2): 58-65 |
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Vahhabi A, Hasani A, Nahaei M, Frajnia ُ. PCR assay for detection of vanA and vanB genes from intestinal carriers of vancomycin-resistant enterococci in three educational hospitals of Tabriz university of medical sciences. Iran J Med Microbiol 2010; 4 (1 and 2) :58-65
URL: http://ijmm.ir/article-1-60-en.html
URL: http://ijmm.ir/article-1-60-en.html
1- Department of Clinical Bacteriology and Virology, Tabriz University of Medical Sciences, Iran , a.vahhabi@yahoo.com
2- Department of Clinical Bacteriology and Viro logy, Research Center of Infectious Diseases and Tropical Medicine, Tabriz University of Medical Sciences, Iran
3- Department of Clinical Bacteriology and Virology, Tabriz University of Medical Sciences, Iran
4- Applied and Drug Research Center, Tabriz University of Medical Sciences, Iran
2- Department of Clinical Bacteriology and Viro logy, Research Center of Infectious Diseases and Tropical Medicine, Tabriz University of Medical Sciences, Iran
3- Department of Clinical Bacteriology and Virology, Tabriz University of Medical Sciences, Iran
4- Applied and Drug Research Center, Tabriz University of Medical Sciences, Iran
Abstract: (22237 Views)
Background and Objectives: Enterococci are increasingly the causative agents of nosocomial infections. Resistance to antibiotics, especially to vancomycin, ampicillin and high levels of aminoglycosides, is typical in these isolates. Rapid and accurate identification of vancomycin-resistant enterococci (VRE) is crucial in the management and treatment of infected patients, which allows for selection of appropriate treatment programs to prevent the spread of VRE. Using a PCR assay for detection of vanA and vanB genes in VRE isolated from intestinal carriers was the aim of this study.
Materials and Methods: A total of 432 rectal swabs or stool specimens were collected from patients hospitalized at high risk wards (ICU, Hematology/Oncology, Infectious and Burn) with a hospital stay of longer than 72 hours or attending out-patient clinics (Hematology/Oncology and Infectious clinics and Hemodialysis) of three university teaching hospitals in Tabriz (sina, children and Shahid Ghazi Tabatabaee hospitals). Specimens were inoculated into specific media and enterococci species were isolated. Determination of minimum inhibitory concentration (MIC) of vancomycin was performed by agar dilution and confirmed by E-test for resistant species. PCR assay was carried out for detection of vanA/vanB genes.
Results: From the 432 stool specimens, 291(67.3%) enterococci species were isolated. 189 (64.9%) were identified as Enterococcus feacalis and 86 (29.5%) as Enterococcus feacium. MIC determination confirmed resistance to vancomycin in 15 (5.1%) strains and all of them were E. faecium. PCR confirmed vanA or vanB genes with moderate (MICs, 8-16 µg/ml) or high level (MICs, ≥256 µg/ml) resistance to vancomycin in 54 (18.5%) of enterococcal species. Finally, 42 (66.6%) of the resistant isolates were E. faecium and 15 (23.8%) were identified to be E. faecalis. Additionally, 54 (85.7%) of the resistant species were isolated from in-patients and 9 (14.2%) from out-patients.
Conclusion: Moderate to high resistance of enterococcal isolates against vancomycin among in-patients and out-patients is a medical concern proposing improvement in treatment policies.
Materials and Methods: A total of 432 rectal swabs or stool specimens were collected from patients hospitalized at high risk wards (ICU, Hematology/Oncology, Infectious and Burn) with a hospital stay of longer than 72 hours or attending out-patient clinics (Hematology/Oncology and Infectious clinics and Hemodialysis) of three university teaching hospitals in Tabriz (sina, children and Shahid Ghazi Tabatabaee hospitals). Specimens were inoculated into specific media and enterococci species were isolated. Determination of minimum inhibitory concentration (MIC) of vancomycin was performed by agar dilution and confirmed by E-test for resistant species. PCR assay was carried out for detection of vanA/vanB genes.
Results: From the 432 stool specimens, 291(67.3%) enterococci species were isolated. 189 (64.9%) were identified as Enterococcus feacalis and 86 (29.5%) as Enterococcus feacium. MIC determination confirmed resistance to vancomycin in 15 (5.1%) strains and all of them were E. faecium. PCR confirmed vanA or vanB genes with moderate (MICs, 8-16 µg/ml) or high level (MICs, ≥256 µg/ml) resistance to vancomycin in 54 (18.5%) of enterococcal species. Finally, 42 (66.6%) of the resistant isolates were E. faecium and 15 (23.8%) were identified to be E. faecalis. Additionally, 54 (85.7%) of the resistant species were isolated from in-patients and 9 (14.2%) from out-patients.
Conclusion: Moderate to high resistance of enterococcal isolates against vancomycin among in-patients and out-patients is a medical concern proposing improvement in treatment policies.
Type of Study: Original Research Article |
Subject:
Nosocomial infections
Received: 2013/11/10 | Accepted: 2013/11/10 | ePublished: 2013/11/10
Received: 2013/11/10 | Accepted: 2013/11/10 | ePublished: 2013/11/10
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