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PubMed2000

Comparison of antimicrobial resistance phenotypes and resistance genes in Enterococcus faecalis and Enterococcus faecium from humans in the community, broilers, and pigs in Denmark.

Enterococcus faecalis and E. faecium isolated from humans in the community (98 and 65 isolates), broilers (126 and 122), and pigs (102 and 88) during 1998 were tested for susceptibility to 12 different antimicrobial agents and for the presence of selected genes encoding resistance using PCR. Furthermore, the presence of vancomycin resistant enterococci was examined in 38 human stool samples using selective enrichment. Widespread resistance to chloramphenicol, macrolides, kanamycin, streptomycin, and tetracycline was found among isolates from all three sources. All E. faecium isolates from humans and pigs were susceptible to avilamycin, whereas 35% of isolates from broilers were resistant. All E. faecium isolates from humans were susceptible to vancomycin, whereas 10% and 17% of isolates from broilers and pigs, respectively, were resistant. A vancomycin resistant E. faecium isolate was found in one of the 38 human fecal samples examined using selective enrichment. All vancomycin resistant isolates contained the vanA gene, all chloramphenicol resistant isolates the cat(pIP501) gene, and all five gentamicin resistant isolates the aac6-aph2 gene. Sixty-one (85%) of 72 erythromycin resistant E. faecalis examined and 57 (90%) of 63 erythromycin resistant E. faecium isolates examined contained ermB. Forty (91%) of the kanamycin resistant E. faecalis and 18 (72%) of the kanamycin resistant E. faecium isolates contained aphA3. The tet(M) gene was found in 95% of the tetracycline resistant E. faecalis and E. faecium isolates of human and animal origin, examined. tet(K) was not observed, whereas tet(L) was detected in 17% of tetracycline resistant E. faecalis isolates and in 16% of the E. faecium isolates. tet(O) was not detected in any of the isolates from pigs, but was observed in 38% of E. faecalis isolates from broilers, in two E. faecalis isolates from humans and in three E. faecium isolates from broilers. tet(S) was not detected among isolates from animals, but was observed in 31% of E. faecalis and one E. faecium isolate from humans. This study showed a frequent occurrence of antimicrobial resistance and the presence of selected resistance genes in E. faecalis and E. faecium isolated from humans, broilers and pigs. Differences in the occurrence of resistance and tetracycline resistance genes were observed among isolates from the different sources. However, similar resistance patterns and resistance genes were detected frequently indicating that transmission of resistant enterococci or resistance genes takes place between humans, broilers, and pigs.

Animals↗
PubMed2001

Comparison of statistical methods for identification of Streptococcus thermophilus, Enterococcus faecalis, and Enterococcus faecium from randomly amplified polymorphic DNA patterns.

Thermophilic streptococci play an important role in the manufacture of many European cheeses, and a rapid and reliable method for their identification is needed. Randomly amplified polymorphic DNA (RAPD) PCR (RAPD-PCR) with two different primers coupled to hierarchical cluster analysis has proven to be a powerful tool for the classification and typing of Streptococcus thermophilus, Enterococcus faecium, and Enterococcus faecalis (G. Moschetti, G. Blaiotta, M. Aponte, P. Catzeddu, F. Villani, P. Deiana, and S. Coppola, J. Appl. Microbiol. 85:25-36, 1998). In order to develop a fast and inexpensive method for the identification of thermophilic streptococci, RAPD-PCR patterns were generated with a single primer (XD9), and the results were analyzed using artificial neural networks (Multilayer Perceptron, Radial Basis Function network, and Bayesian network) and multivariate statistical techniques (cluster analysis, linear discriminant analysis, and classification trees). Cluster analysis allowed the identification of S. thermophilus but not of enterococci. A Bayesian network proved to be more effective than a Multilayer Perceptron or a Radial Basis Function network for the identification of S. thermophilus, E. faecium, and E. faecalis using simplified RAPD-PCR patterns (obtained by summing the bands in selected areas of the patterns). The Bayesian network also significantly outperformed two multivariate statistical techniques (linear discriminant analysis and classification trees) and proved to be less sensitive to the size of the training set and more robust in the response to patterns belonging to unknown species.

Bayes Theorem↗
PubMed2006

Prevalence of aminoglycoside-modifying enzymes genes among isolates of Enterococcus faecalis and Enterococcus faecium in Iran.

Disks containing 120 microg of gentamicin were used to detect high-level gentamicin-resistant phenotype (HLGR) among isolates of Enterococcus faecalis (n = 79) and E. faecium (n = 35). These isolates were collected from three hospitals in Tehran during 2002-2004. The macrobroth dilution assay was then used to determine the minimum inhibitory concentration (MIC) of gentamicin. The susceptibility of isolates against amikacin, netilmicin, tobramycin, and kanamycin were also determined by Kirby-Bauer method. All isolates were subjected to polymerase chain reaction (PCR) assays targeting aminoglycoside modifying enzyme (AMEs) genes including aac(6 ')-aph(2 "), aph(2 ")-Ib, aph(2 ")-Ic, aph(2 ")-Ia, aph(2 ")-Id, aph(3 ')-IIIa, and ant(4 ')-Ia. Fifty-nine isolates (52%) showed HLGR phenotype. All isolates with HLGR phenotype and those showing 64 < MIC < 500 microg/ml contained aac(6 ')-aph(2 "). The aph(3 ')-IIIa was found in 61% of the isolates with HLGR phenotypes and in 65% of isolates with MIC < 500. Coexistence of aac(6 ')-aph(2 ") and aph(3 ')-IIIa gene among HLGR isolates of E. faecalis and E. faecium were 60% and 65%, respectively. The gene aph(2 ")-Ic was amplified in two isolates of E. faecium. The results of PCR for aph(2 ")-Id, ant(4 ')-Ia and aph(2 ")-Ib genes were negative. The aac(6 ')-aph(2 ") was the most frequent gene encoding resistance to gentamicin and other aminoglycosides followed by aph(3 ')-IIIa. Isolates lacking these genes were susceptible to all aminoglyocosides tested in this study.

Aminoglycosides↗
PubMed2000

[Prevalence of Enterococcus faecalis and Enterococcus faecium with high resistance to aminoglycosides in the cities of Resistencia and Corrientes, Republic of Argentina].

BACKGROUND: The objective of this study was characterize the prevalence of high-level aminoglycosides resistance (HLRA) in Enterococcus faecalis and E. faecium, determine the relationship between high-level gentamicin resistance (HLGR) and other aminoglycosides, and their distribution according clinical samples (blood, urine and others). MATERIALS AND METHOD: A total of 177 strain (157 E. faecalis and 20 E. faecium) isolated from 1996 to 1998 were studied. They were identified by using classic methods. Their susceptibility to gentamicin, streptomycin, and kanamycin was tested by the disk diffusion technique using high-level disks in agar Müller Hinton. RESULTS: E. faecalis showed HLRG of 28.7%, streptomycin 28.7% and kanamycin 37.6%, E. faecium showed 50%, 40%, and 60% respectively. The strains with HLRA have a tendency to high-level resistances to streptomycin and kanamycin (p < 0.0005). Statistical analysis demonstrated significative differences among strains with HLRA isolated from blood, urine and other clinical samples (p < 0.0005 to gentamicin and streptomycin and 0.004 < p < 0.007 to kanamycin). CONCLUSIONS: The prevalence of HLRA enterococci found in the area os this study, justify its detection, particularity in cases of serious infections.

Aminoglycosides↗
PubMed2005

[Factors of virulence and mechanisms of resistance to aminoglycosides in clinical isolates of Enterococcus faecalis and Enterococcus faecium with high-level gentamicin resistance].

Enterococcus faecalis and E. faecium are grampositive commensal bacteria that may become pathogenic under the selection pressure. In view of natural resistance and effective mechanisms of genetic transfer, the treatment of enterococcal diseases is rather complicated. Aminoglycosides are clinically relevant antimicrobials that are frequently prescribed in practice since having good pharmacokinetics and showing synergism with beta-lactam and glycopeptides. One of the major mechanisms involved in aminoglycoside resistance is inactivation of the antibiotic agent by aminoglycoside-modifying enzymes (AGMEs) differing in the capacity for inactivation of specific types of aminoglycosides. The factors of virulence are also involved in enterococcal pathogenicity but their role in the pathogenesis of infectious diseases remains unclear. Production of beta-hemolysin (Hly), gelatinase (Gel), and aggregation substance (AS), and synthesis of enterococcal surface protein (Esp) are among the most frequently studied potential virulence factors.

Drug Resistance, Bacterial↗
PubMed1993

A gene conferring resistance to vancomycin but not teicoplanin in isolates of Enterococcus faecalis and Enterococcus faecium demonstrates homology with vanB, vanA, and vanC genes of enterococci.

We report the sequence of a 630-bp fragment of a gene associated with resistance to high levels of vancomycin in a clinical isolate of Enterococcus faecalis which retained susceptibility to teicoplanin. This gene was similar to the recently sequenced vanB and partially homologous with vanA, but it showed less-marked similarity to vanC. A DNA probe, derived from this polymerase chain reaction-amplified gene fragment, hybridized specifically with genomic DNA from Enterococcus faecium and E. faecalis isolates which were vancomycin resistant (MICs ranged from 8 to 512 micrograms/ml) but susceptible to teicoplanin. Curing of vancomycin resistance was associated with loss of DNA hybridization with the gene probe. Transfer of DNA which hybridized with the probe accompanied transfer of vancomycin resistance to a susceptible recipient strain. Neither curing nor transfer of vancomycin resistance was consistently related to loss or acquisition, respectively, of plasmid DNA.

Amino Acid Sequence↗
PubMed1990

[The conjugative transfer of beta-hemolysin plasmid in Enterococcus faecalis to Enterococcus faecium].

The conjugative transfer by using a filter mating method in 109 cases of combinations between 20 strains of beta-hemolytic Enterococcus faecalis and 28 strains of alpha-hemolytic Enterococcus faecium was tried. A stable transconjugation was observed in two cases: from E. faecalis No. 170 to E. faecium No. 49 and from E. faecalis No. 500 to E. faecium No. 48. From the results, it was proved that the beta-hemolysin plasmid of E. faecalis is transferred by conjugation to E. faecium. The virulence (LD50) of E. faecium No. 17049, No. 50048 (heterogeneous transconjugant) and E. faecalis No. 17067, No. 50067 (homologous transconjugant) in mice was compared with their parent strains. The virulence of E. faecalis transconjugants was more marked than that of the recipients. However, the virulence of E. faecium transconjugants was not enhanced. This fact suggests that, only in E. faecalis, does beta-hemolysin play a role in its pathogenicity in mice. beta-Hemolysin in E. faecium transconjugants does not participate in pathogenicity in mice. It may be due to the fact that it takes more time to cause beta-hemolysis on blood agar plate or beta-hemolysin production in B-YEG broth by E. faecium transconjugants than by E. faecalis transconjugants.

Animals↗
PubMed2003

Effect of various growth media upon survival during storage of freeze-dried Enterococcus faecalis and Enterococcus durans.

AIMS: The effects of three different growth media (MRS, M17 and Lee's) on survival during freeze-drying and subsequent storage of six strains of Enterococcus faecalis and two strains of E. durans were investigated. METHODS AND RESULTS: Distinct Enterococcus spp. strains were grown on M17, MRS and Lee's broth, freeze-dried and stored at 20 degrees C in air under darkness. At regular intervals throughout storage, freeze-dried samples were rehydrated and then plated on M17 agar. CONCLUSIONS: A higher survival rate during storage of dried E. durans was obtained when growth occurred in MRS. The same effect was not observed, however, for the majority of E. faecalis strains, which clearly survived better in the dried state when this organism had been grown in M17 or Lee's medium. SIGNIFICANCE AND IMPACT OF STUDY: The survival of the dried Enterococcus spp. tested during storage was shown to be strain-specific and dependent on the growth medium.

Culture Media↗
PubMed1996

Acidification of methyl-alpha-D-glucopyranoside: a useful test to differentiate Enterococcus casseliflavus and Enterococcus gallinarum from Enterococcus faecium species group and from Enterococcus faecalis.

Enterococcus gallinarum and E. casseliflavus are difficult to differentiate from other enterococci, particularly E.faecium. The former two species were found to produce acid from methyl-alpha-D-glucopyranoside in phenol red broth, while E.faecalis strains and strains of the E.faecium species group, including E.faecium, E.durans, E. hirae, and E.mundtii, failed to produce acid from this substrate.

Bacterial Typing Techniques↗
PubMed2004

The tyrosine decarboxylation test does not differentiate Enterococcus faecalis from Enterococcus faecium.

According to the current edition of the Bergey's Manual of Systematic Bacteriology [11] the tyrosine decarboxylation test allows the differentiation of enterococci. Tyrosine is decarboxylated to the biogenic amine tyramine by E. faecalis and not by E. faecium strains. In the present study we sequenced the16S rDNA of two tyramine-producing strains, BIFI-56 and BIFI-58, presumptively classified as E. faecalis. Their 16S rDNA were identical to the same fragment from the E. faecium type strain. Several E. faecium strains were then checked for their ability to decarboxylate tyrosine and also a putative tyrosine decarboxylase-coding gene was PCR amplified from these strains. All the strains confirmed as E. faecium produced tyramine and possessed a DNA fragment coding for a putative tyrosine decarboxylase. The concordance of the two methods allows us to conclude that the tyrosine decarboxylase test cannot be used in the differentiation of E. faecalis from E. faecium since at least some E. faecium strains are tyramine producers.

Bacterial Typing Techniques↗
PubMed1991

Separation of the poly(glycerophosphate) lipoteichoic acids of Enterococcus faecalis Kiel 27738, Enterococcus hirae ATCC 9790 and Leuconostoc mesenteroides DSM 20343 into molecular species by affinity chromatography on concanavalin A.

This study shows for the first time microheterogeneity of 1,3-linked poly(glycerophosphate) lipoteichoic acids. The lipoteichoic acids investigated were those of Enterococcus faecalis Kiel 27738 (I), Enterococcus hirae (Streptococcus faecium) ATCC 9790 (II), and Leuconostoc mesenteroides DMS 20343 (III). Lipoteichoic acids II and III are partially substituted by mono-, di-, tri-, and tetra-alpha-D-glucopyranosyl residues with (1----2) interglycosidic linkages. Lipoteichoic acid I is substituted with alpha-kojibiosyl residues only. Lipoteichoic acids I and III additionally carry D-alanine ester. Lipoteichoic acids were separated on columns of concanavalin-A-Sepharose according to their increasing number of glycosyl substituents per chain. It was evident that all molecular species are usually glycosylated and that alanine ester and glycosyl residues occur on the same chains. The chain lengths of lipoteichoic acid I and II vary between 9-40 glycerophosphate residues, whereas those of lipoteichoic acid III appear to be uniform (33 +/- 2 residues). Molecular species differ in the extent of glycosylation but their content of alanyl residues is fairly constant. All lipoteichoic acids contain a small fraction (5-15%) different in composition from the bulk and most likely reflecting an early stage of biosynthesis. Two procedures for chain length determination of poly(glycerophosphate) lipoteichoic acids are described.

Chromatography, Affinity↗
PubMed2006

Comparative study of vanA gene transfer from Enterococcus faecium to Enterococcus faecalis and to Enterococcus faecium in the intestine of mice.

Vancomycin-resistant enterococci represent a large reservoir in animals because of the use of avoparcin as a growth promoter in Europe. These strains of animal origin enter the food chain and can either colonize the human gut or transfer their resistance genes to the human microbiota. In this study, we compared the transfer of vancomycin resistance from resistant animal Enterococcus faecium to sensitive human Enterococcus faecalis and E. faecium. We analysed these transfers in dibiotic mice and human faecal flora-associated mice. VanA transfer from animal E. faecium to human E. faecalis occurred in dibiotic mice. The transconjugants appeared rapidly and persisted at levels between 3.0 and 4.0 log10 colony-forming units g(-1) of faeces. In human faecal flora-associated mice, vanA gene transfer was not detected towards E. faecalis but was possible between E. faecium strains. Our experiments revealed the possibility of vanA transfer from animal E. faecium to human E. faecalis in vitro and in vivo in the intestine of dibiotic mice. However, intraspecies transfer of vanA gene seems more common than interspecies transfer among enterococci.

Animals↗
PubMed2006

Risk factors and outcomes associated with non-Enterococcus faecalis, non-Enterococcus faecium enterococcal bacteremia.

OBJECTIVES: To compare risk factors, clinical features, and outcomes in patients with Enterococcus avium, Enterococcus casseliflavus, Enterococcus durans, Enterococcus gallinarum, and Enterococcus mundtii bacteremia (cases) with those in patients with Enterococcus faecalis bacteremia (controls). DESIGN: A retrospective case-control study. SETTING: A 725-bed, university-affiliated, academic medical center. PATIENTS: The clinical microbiology database at Northwestern Memorial Hospital from January 1994 to May 2003 was searched to identify cases; each case was matched to one control on the basis of date of admission. RESULTS: Thirty-three cases were identified and matched with 33 controls. The mean duration of hospital stay was longer (29.7 vs 17.2 days; P = .03) and the mean time to acquisition of bacteremia was greater (16.5 vs 6.3 days; P = .003) for cases than controls. Cases were more likely to have underlying hematologic malignancies (P < .001), to have been treated with corticosteroids (P = .02), and to be neutropenic (P = .003). Controls were more likely to have an indwelling bladder catheter (P = .01), and cases were more likely to have the gastrointestinal tract as a source of infection (P = .007) and to have concurrent cholangitis (P = .002). There were no differences in severity of illness or in mortality rates. CONCLUSIONS: Compared with patients with E. faecalis bacteremia, patients with non-E. faecalis, non-Enterococcus faecium enterococcal bacteremia were more likely to have a hematologic malignancy, prior treatment with corticosteroids, neutropenia, and cholangitis; longer duration of hospital stay was also identified as a clinical feature. However, non-E. faecalis, non-E. faecium species are not associated with any differences in mortality.

Bacteremia↗
PubMed2001

Characteristics and glycerol metabolism of fumarate-reducing Enterococcus faecalis RKY1.

Enterococcus faecalis RKY1, which converts fumarate to succinate with a high yield, was identified on the basis of a phylogenetic analysis of the 16S rDNA gene sequence. The strain was incubated at 38 degrees C for 18 h to examine the possible diversion of glucose or glycerol fermentation by fumarate. The products of glucose and glycerol fermentation with fumarate were quite different from those of normal fermentation, which ultimately produces lactate, in that mainly succinate is produced. Metabolic pathway stoichiometry was used to analyze the oxidation of glycerol to succinate by Enterococcus faecalis RKY1. The stoichiometric relationship between glycerol and fumarate was used as a guideline to accumulate succinate more efficiently.

DNA, Ribosomal↗