Virulence genes and antibiograms of Enterococci isolated from Intensive Care Unit patients in National Liver Institute

Document Type : New and original researches in the field of Microbiology.

Authors

1 Medical Microbiology & Immunology Department, National Liver Institute, Menoufia University

2 Anaesthesia and intensive care Department, National Liver Institute - Menoufia University

Abstract

Background: Enterococci are normal flora of human intestine causing several infections such as infective endocarditis, bloodstream infections, and intra pelvic/abdominal abscess especially among patients in ICU. Different virulent factors are produced by the bacterium to enhance their pathogenicity. Objectives: The aim of the study was to evaluate virulence genes and pattern of antibiotic susceptibility of Enterococcus spp. taken from ICU patients admitted at NLI. Methodology: From 140 ICU patients admitted at NLI, samples were taken after 48 hours from admission, and cultured on bile esculin agar, the GP-ID cards of VITEK-2 system used to confirm enterococcal isolation and species identification. Antibiotic susceptibility was done using VITEK2 AST-P592 cards. Multiplex-PCR was used for identification of gelE, asa1, esp genes. Results: esp gene was significantly high in E. faecium (p =0.004). The virulence genes combinations were significant between the enterococcal species (p = 0.004). A significant correlation was found between Enterococci isolates clinical source and esp gene (p =0.012). Antibiotic susceptibilities were variable among enterococcal isolates. The resistance to ampicillin and streptomycin (high level synergy) was significant between E. faecium and E. faecalis (p =0.014, 0.006) respectively. No association was observed regarding antibiotic susceptibility with genes of virulence (p > 0.05). Conclusion: A relationship was found between distribution pattern of virulence genes and the enterococcal species. A correlation was found between Enterococci isolates clinical source and esp gene. Antibiotic resistance was significantly different between the enterococcal species. Surveillance of drug resistance should be done regularly for proper antibiotics selection.

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