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Palmieri A, Martinelli M, Pellati A, Carinci F, Lauritano D, Arcuri C, Baggi L, Gatto R, Scapoli L. Prevalence of Enterococci and Vancomycin Resistance in the Throat of Non-Hospitalized Individuals Randomly Selected in Central Italy. Antibiotics (Basel) 2023; 12:1161. [PMID: 37508257 PMCID: PMC10376521 DOI: 10.3390/antibiotics12071161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/26/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
Enterococci are commonly found in the environment and humans as a part of the normal microbiota. Among these, Enterococcus faecalis and Enterococcus faecium can convert into opportunistic pathogens, making them a major cause of nosocomial infections. The rapid diffusion of vancomycin-resistant strains and their impact on nosocomial settings is of considerable concern. Approximately one-third of the E. faecium infections in Italy are caused by vancomycin-resistant strains. This study explored the hypothesis that the oral cavity could represent a silent reservoir of virulent enterococci. A sample of 862 oral flora specimens collected from healthy human volunteers in Central Italy was investigated by real-time PCR to detect E. faecalis and E. faecium, as well as the genetic elements that most frequently determine vancomycin resistance. The prevalence of E. faecalis was 19%, a value that was not associated with alcohol consumption, tobacco smoking, or age of the subjects. Less frequently detected, with an overall prevalence of 0.7%, E. faecium was more common among people older than 49 years of age. The genes conferring vancomycin resistance were detected in only one sample. The results indicate that the oral cavity can be considered a reservoir of clinically relevant enterococci; however, our data suggest that healthy individuals rarely carry vancomycin-resistant strains.
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Affiliation(s)
- Annalisa Palmieri
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Marcella Martinelli
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Agnese Pellati
- Department of Translational Medicine and for Romagna, University of Ferrara, 44121 Ferrara, Italy
| | - Francesco Carinci
- Department of Translational Medicine and for Romagna, University of Ferrara, 44121 Ferrara, Italy
| | - Dorina Lauritano
- Department of Translational Medicine and for Romagna, University of Ferrara, 44121 Ferrara, Italy
| | - Claudio Arcuri
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", 00113 Rome, Italy
| | - Luigi Baggi
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", 00113 Rome, Italy
| | - Roberto Gatto
- Department of Life, Health and Environmental Sciences, School of Dentistry, University of L'Aquila, 67100 L'Aquila, Italy
| | - Luca Scapoli
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
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Hasanpour F, Neyestani Z, Arzanlou M, Moradi-Asl E, Sahebkar A, Khademi F. Vancomycin-resistant enterococci in Iran: A systematic review and meta-analysis of non-clinical studies. GENE REPORTS 2021. [DOI: 10.1016/j.genrep.2021.101265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lawpidet P, Tengjaroenkul B, Saksangawong C, Sukon P. Global Prevalence of Vancomycin-Resistant Enterococci in Food of Animal Origin: A Meta-Analysis. Foodborne Pathog Dis 2021; 18:405-412. [PMID: 33684315 DOI: 10.1089/fpd.2020.2892] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Vancomycin-resistant enterococci (VRE) are a leading cause of nosocomial infections in patients worldwide. VRE contamination in food of animal origin may create a risk for human health. This study was conducted to estimate the pooled prevalence of VRE in food of animal origin worldwide, to assess the result heterogeneity, and to determine cumulative evidence and the trend of the prevalence over time. Relevant studies were retrieved from PubMed, Scopus, and Web of Science. A random-effects model was used to calculate the pooled prevalence of VRE in food of animal origin. Subgroup meta-analysis was used to assess the heterogeneity of the results. A cumulative meta-analysis and meta-regression were conducted to determine cumulative evidence and the trend of the prevalence of VRE in food of animal origin over time, respectively. Of the 1352 retrieved studies, 50 articles were included. The pooled prevalence of VRE in food of animal origin was 11.7% (95% confidence interval [95% CI] = 8.4 to 16.0). Subgroup meta-analyses showed a significant difference in the prevalence of VRE for two characteristics. First, for the source of food, the prevalence of VRE was highest in aquatic food (43.4% [95% CI = 28.4 to 59.7]) and lowest in dairy food (4.1% [95% CI = 1.7 to 9.8]). Second, for continents, the prevalence of VRE was highest in Africa (18.5% [95% CI = 12.8 to 26.1]) and lowest in North America (0.3% [95% CI = 0.1 to 1.1]). Cumulative evidence showed two distinct features in two different periods. The pooled prevalence of VRE rapidly decreased from 79.3% in 1998 to 13.1% in 2003; it has slightly fluctuated between 10.5% and 20.5% since 2004. The results of the meta-regression indicated that the prevalence gradually decreased over time. In conclusion, the estimate of overall VRE prevalence worldwide in food of animal origin was ∼12%, indicating the burden of VRE contamination in food of animal origin.
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Affiliation(s)
| | - Bundit Tengjaroenkul
- Faculty of Veterinary Medicine, Khon Kaen University, Khon Kaen, Thailand.,Research and Development on Toxic Substances, Microorganisms and Feed Additives in Livestock and Aquatic Animals for Food Safety, Khon Kaen University, Khon Kaen, Thailand
| | | | - Peerapol Sukon
- Faculty of Veterinary Medicine, Khon Kaen University, Khon Kaen, Thailand.,Research and Development on Toxic Substances, Microorganisms and Feed Additives in Livestock and Aquatic Animals for Food Safety, Khon Kaen University, Khon Kaen, Thailand
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Gotkowska-Płachta A. The Prevalence of Virulent and Multidrug-Resistant Enterococci in River Water and in Treated and Untreated Municipal and Hospital Wastewater. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020563. [PMID: 33440863 PMCID: PMC7827636 DOI: 10.3390/ijerph18020563] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/06/2021] [Accepted: 01/08/2021] [Indexed: 01/12/2023]
Abstract
The aim of this study is to describe the drug resistance and virulence of enterococci in river water sampled downstream (DRW) and upstream (URW) from the wastewater discharge point, to determine the pool of virulent and drug-resistant enterococci in untreated wastewater (UWW) and the extent to which these bacteria are eliminated from hospital wastewater (HWW) and municipal wastewater treated (TWW) by biological and mechanical methods in a wastewater treatment plant (WWTP). A total of 283 strains were identified with the use of culture-dependent methods and PCR, including seven different species including E. faecalis and E. faecium which were predominant in all analyzed samples. Majority of the strains were classified as multidrug resistant (MDR), mostly on streptomycin and trimethoprim. Strains isolated from wastewater and DRW harbored van genes conditioning phenotypic resistance to vancomycin, the highest percentage of vancomycin-resistant strains (57.0%), mostly strains harboring vanC1 genes (27.6%), was noted in TWW. More than 65.0% of the isolated strains had different virulence genes, the highest number of isolates were positive for cell wall adhesin efaA and sex pheromones cob, cpd, and ccf which participate in the induction of virulence. Many of the strains isolated from TWW were resistant to a higher number of drugs and were more virulent than those isolated from UWW and HWW. The enterococci isolated from DRW and wastewater were characterized by similar multidrug resistance and virulence profiles, and significant correlations were observed between these groups of isolates. These findings suggest that pathogenic enterococci are released with TWW and can spread in the river, pose a serious epidemiological threat and a risk to public health.
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Affiliation(s)
- Anna Gotkowska-Płachta
- Department of Water Protection Engineering and Environmental Microbiology, The faculty of Geoengineering University of Warmia and Mazury in Olsztyn, Prawocheńskiego 1, 10-719 Olsztyn, Poland
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Abstract
Enterococci are natural inhabitants of the intestinal tract in humans and many animals, including food-producing and companion animals. They can easily contaminate the food and the environment, entering the food chain. Moreover, Enterococcus is an important opportunistic pathogen, especially the species E. faecalis and E. faecium, causing a wide variety of infections. This microorganism not only contains intrinsic resistance mechanisms to several antimicrobial agents, but also has the capacity to acquire new mechanisms of antimicrobial resistance. In this review we analyze the diversity of enterococcal species and their distribution in the intestinal tract of animals. Moreover, resistance mechanisms for different classes of antimicrobials of clinical relevance are reviewed, as well as the epidemiology of multidrug-resistant enterococci of animal origin, with special attention given to beta-lactams, glycopeptides, and linezolid. The emergence of new antimicrobial resistance genes in enterococci of animal origin, such as optrA and cfr, is highlighted. The molecular epidemiology and the population structure of E. faecalis and E. faecium isolates in farm and companion animals is presented. Moreover, the types of plasmids that carry the antimicrobial resistance genes in enterococci of animal origin are reviewed.
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Sanlibaba P, Tezel BU, Senturk E. Antimicrobial Resistance of Enterococcus Species Isolated from Chicken in Turkey. Korean J Food Sci Anim Resour 2018; 38:391-402. [PMID: 29805287 PMCID: PMC5960835 DOI: 10.5851/kosfa.2018.38.2.391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 03/08/2018] [Accepted: 03/28/2018] [Indexed: 11/30/2022] Open
Abstract
The aim of the present work was to provide information about Enterococcus strains isolated from pre-packaged chicken samples in Ankara (Turkey), focusing on their prevalence, phenotypic and genotypic characteristics, and antibiotic resistance. We report the first study on the occurrence of antibiotic resistant enterococci in pre-packaged chicken samples in Ankara. A total of 97 suspicious enterococcal isolates were identified from 122 chicken samples. All isolates were identified to species level by phenotypic and molecular methods. In the 16S rDNA sequence analysis, Enterococcus faecium (61.85%) and Enterococcus faecalis (38.15%) were found to be the most frequently detected Enterococcus spp. Of the 97 isolates tested for hemolytic activity, 12.37% enterococcal strains were β-hemolytic. β-Hemolysin was most prevalent among E. faecium (58.33%) compared to E. faecalis (41.66%). Disk diffusion method was used for determining of antibiotic resistance. The analysis of the antimicrobial resistance of the 97 Enterococcus isolates revealed that the resistance to kanamycin (98.96%), rifampicin (80.41%) and ampicillin (60.82%) was most frequent. Furthermore, resistance to erythromycin (38.14%) and ciprofloxacin (34.02%) was also observed. The frequencies of resistance to tetracycline (9.27%), penicillin G (8.24%), and chloramphenicol (3.09%), gentamicin (2.06%) and streptomycin (1.03%) were low. None of the isolates was resistant to vancomycin. Multi-drug resistance was found in 97.93% of Enterococcus strains. E. faecium strains showed a more resistant phenotype than E. faecalis strains according to the antibiotic resistance levels. The results of this study indicated that chicken meat is a potential reservoir for the transmission of antibiotic resistance from animals to humans.
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Affiliation(s)
- Pınar Sanlibaba
- Department of Food Engineering, Faculty of Engineering, Ankara University, 06830, Gölbaşı, Ankara, Turkey
| | - Basar Uymaz Tezel
- Bayramiç Vocational School, Food Technology Program, Çanakkale Onsekiz Mart University, 17700, Bayramiç, Çanakkale, Turkey
| | - Esra Senturk
- Department of Food Engineering, Faculty of Engineering, Ankara University, 06830, Gölbaşı, Ankara, Turkey
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Isolation of Methicillin-Resistant Staphylococcus aureus Strains Producing Enterotoxins A, K and Q From Chicken Meat in Isfahan, Iran, 2014. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2016. [DOI: 10.5812/archcid.35601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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