PREVALENCE OF VANCOMYCIN RESISTANT ENTEROCOCCI FROM URINARY TRACT INFECTED PATIENTS
DOI:
https://doi.org/10.22159/ijpps.2023v15i1.45380Keywords:
Enterococcus, Urinary tract infections, Vancomycin, Antibiotic resistanceAbstract
Urinary tract infections (UTIs) are one of the infectious diseases affecting humankind. The microbial agents that infect the tissues of the urinary tract from the renal cortex to the urethral meatus Enterococci are opportunistic pathogens that are found in the normal gut flora. Enterococci are the second leading cause of UTIs, accounting for 10% of all nosocomial UTIs. This species has become a major pathogen in the United States, Iran, Europe, and other parts of the world, including India. Antibiotic resistance is increasing, which slows the rate of progress in practical therapies, making susceptibility testing necessary. So, enterococci were isolated from urine samples of patients with UTI that were subjected to morphological characterization, biochemical assays, etc., The main aim of the study was to help in identifying resistance patterns and the dispersal of Enterococcus strains from various samples of urine to antibiotic agents like Penicillin G, Tetracycline, Teicoplanin, Norfloxacin, high-level Gentamycin, Linezolid, Nitrofurantoin, and with special emphasis on Vancomycin antibiotic. The greatest threat posed by Vancomycin-Resistant Enterococci (VRE) is its ability to transfer resistance genes to more dangerous gram-positive bacteria, potentially leading to truly terrifying pathogens in the future. A long stay in the hospital and the use of Vancomycin were connected to VRE-UTI and colonisation. Renal dialysis, renal failure, previous aminoglycoside, and third-generation cephalosporin use were all relevant hazard factors for VRE from UTI. The paper also underlines the importance of screening clinical samples for VRE and proposes that control measures be implemented to limit the spread of VRE.
Downloads
References
Lee JBL, Neild GH. Urinary tract infection. Medicine. 2007 Aug 1;35(8):423-8. doi: 10.1016/j.mpmed.2007.05.009.
Tacconelli E, Cataldo MA. Vancomycin-resistant Enterococci (VRE): transmission and control. Int J Antimicrob Agents. 2008 Feb 1;31(2):99-106. doi: 10.1016/j.ijantimicag.2007.08.026, PMID 18164908.
Tacconelli E, Karchmer AW, Yokoe D, D’Agata EM. Preventing the influx of vancomycin-resistant Enterococci into health care institutions by use of a simple validated prediction rule. Clin Infect Dis. 2004 Oct 1;39(7):964-70. doi: 10.1086/423961, PMID 15472847.
Moellering H. Opportunities for use of the spatial data transfer standard at the state and local level. Cartogr Geogr Inf Syst. 1992 Jan 1;19(5):332-4. doi: 10.1559/152304092783762173.
Kim HS, Kim DH, Yoon HJ, Lee WJ, Woo SH, Choi SP. Factors associated with vancomycin-resistant Enterococcus colonization in patients transferred to emergency departments in Korea. J Korean Med Sci. 2018 Nov 1;33(48):e295. doi: 10.3346/jkms.2018.33.e295, PMID 30473648.
Arias CA, Murray BE. The rise of the Enterococcus: beyond vancomycin resistance. Nat Rev Microbiol. 2012 Apr;10(4):266-78. doi: 10.1038/nrmicro2761, PMID 22421879.
Hidron AI, Edwards JR, Patel J, Horan TC, Sievert DM, Pollock DA. NHSN annual update: antimicrobial-resistant pathogens associated with healthcare-associated infections: annual summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006-2007. Infect Control Hosp Epidemiol. 2008 Nov;29(11):996-1011. doi: 10.1086/591861, PMID 18947320.
Kline KA, Lewis AL. Gram-positive uropathogens, polymicrobial urinary tract infection, and the emerging microbiota of the urinary tract. Microbiol Spectr. 2016 Mar 11;4(2):4-2. doi: 10.1128/microbiolspec.UTI-0012-2012, PMID 27227294.
Swaminathan S, Alangaden GJ. Treatment of resistant enterococcal urinary tract infections. Curr Infect Dis Rep. 2010 Nov;12(6):455-64. doi: 10.1007/s11908-010-0138-8, PMID 21308555.
Flores Mireles AL, Walker JN, Caparon M, Hultgren SJ. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol. 2015 May;13(5):269-84. doi: 10.1038/nrmicro3432, PMID 25853778.
Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. Am J Med. 2002 Jul 8;113(1)Suppl 1A:5S-13S. doi: 10.1016/s0002-9343(02)01054-9, PMID 12113866.
Falcone M, Russo A, Venditti M. Optimizing antibiotic therapy of bacteremia and endocarditis due to Staphylococci and Enterococci: new insights and evidence from the literature. J Infect Chemother. 2015 May 1;21(5):330-9. doi: 10.1016/j.jiac.2015.02.012, PMID 25813608.
Shigemura K, Tanaka K, Okada H, Nakano Y, Kinoshita S, Gotoh A. Pathogen occurrence and antimicrobial susceptibility of urinary tract infection cases during a 20y period (1983-2002) at a single institution in Japan. Jpn J Infect Dis. 2005 Oct 1;58(5):303-8. PMID 16249626.
Sood S, Malhotra M, Das BK, Kapil A. Enterococcal infections and antimicrobial resistance. Indian J Med Res. 2008 Aug 1;128(2):111-21. PMID 19001673.
Bagshaw SM, Laupland KB. Epidemiology of intensive care unit-acquired urinary tract infections. Curr Opin Infect Dis. 2006 Feb 1;19(1):67-71. doi: 10.1097/01.qco.0000200292.37909.e0, PMID 16374221.
Kotagiri P, Chembolli D, Ryan J, Hughes PD, Toussaint ND. Urinary tract infections in the first year post–kidney transplantation: potential benefits of treating asymptomatic bacteriuria. In Transplantation Proc. 2017 Nov 1;49(9):2070-5. doi: 10.1016/j.transproceed.2017.07.008, PMID 29149963
Huang Z, Xiao H, Li H, Yan W, Ji Z. Analysis of the incidence and risk factors of male urinary tract infection following urodynamic study. Eur J Clin Microbiol Infect Dis. 2017 Oct;36(10):1873-8. doi: 10.1007/s10096-017-3007-7, PMID 28577157.
Giannakopoulos X, Sakkas H, Ragos V, Tsiambas E, Bozidis P, M Evangelou AM. Impact of enterococcal urinary tract infections in immunocompromised – neoplastic patients. J BUON. 2019 Sep 1;24(5):1768-75. PMID 31786836.
Kalal BS, Nagaraj S. Urinary tract infections: a retrospective, descriptive study of causative organisms and antimicrobial pattern of samples received for culture, from a tertiary care setting. GERMS. 2016;6(4):132-38. doi: 10.11599/germs.2016.1100, PMID 28053916.
O’Driscoll T, Crank CW. Vancomycin-resistant enterococcal infections: epidemiology, clinical manifestations, and optimal management. Infect Drug Resist. 2015;8:217-30. doi: 10.2147/IDR.S54125, PMID 26244026.
Vasudevan R. Urinary tract infection: an overview of the infection and the associated risk factors. JMEN. 2014;1(2). doi: 10.15406/jmen.2014.01.00008.
Fisher K, Phillips C. The ecology, epidemiology and virulence of Enterococcus. Microbiology (Reading). 2009;155(6):1749-57. doi: 10.1099/mic.0.026385-0, PMID 19383684.
Kajihara T, Nakamura S, Iwanaga N, Oshima K, Takazono T, Miyazaki T. Clinical characteristics and risk factors of enterococcal infections in Nagasaki, Japan: a retrospective study. BMC Infect Dis. 2015;15:426. doi: 10.1186/s12879-015-1175-6, PMID 26471715.
Murray BE. The life and times of the Enterococcus. Clin Microbiol Rev. 1990 Jan;3(1):46-65. doi: 10.1128/CMR.3.1.46, PMID 2404568.
Garner JS. Hospital infection control practice advisory committee. Guideline for isolation precautions in hospitals. The Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol. 1996;17(1):53-80. doi: 10.1086/647190, PMID 8789689.
Keighley MR, Burdon DW, Arabi YA, Williams JA, Thompson H, Youngs D. Randomised controlled trial of vancomycin for pseudomembranous colitis and postoperative diarrhoea. Br Med J. 1978 Dec 16;2(6153):1667-9. doi: 10.1136/bmj.2.6153.1667, PMID 367509.
Mogg GA, Keighley MR, Burdon DW, Alexander Williams J, Youngs D, Johnson M. Antibiotic-associated colitis-a review of 66 cases. Br J Surg. 1979 Oct;66(10):738-42. doi: 10.1002/bjs.1800661017, PMID 509051.
Arthur MI, Molinas C, Depardieu F, Courvalin P. Characterization of Tn1546, a Tn3-related transposon conferring glycopeptide resistance by synthesis of depsipeptide peptidoglycan precursors in Enterococcus faecium BM4147. J Bacteriol. 1993 Jan;175(1):117-27. doi: 10.1128/jb.175.1.117-127.1993, PMID 8380148.
Boyce JM, Mermel LA, Zervos MJ, Rice LB, Potter Bynoe G, Giorgio C. Controlling vancomycin-resistant enterococci. Infect Control Hosp Epidemiol. 1995 Nov;16(11):634-7. doi: 10.1086/647028, PMID 8601683.
Boyce JM, Opal SM, Chow JW, Zervos MJ, Potter Bynoe G, Sherman CB. Outbreak of multidrug-resistant Enterococcus faecium with transferable vanB class vancomycin resistance. J Clin Microbiol. 1994 May;32(5):1148-53. doi: 10.1128/jcm.32.5.1148-1153.1994, PMID 8051238.
Chia JK, Nakata MM, Park SS, Lewis RP, McKee B. Use of bacitracin therapy for infection due to vancomycin-resistant Enterococcus faecium. Clin Infect Dis. 1995 Dec 1;21(6):1520. doi: 10.1093/clinids/21.6.1520, PMID 8749657.
Dembry LM, Uzokwe K, Zervos MJ. Control of endemic glycopeptide-resistant Enterococci. Infect Control Hosp Epidemiol. 1996 May;17(5):286-92. doi: 10.1086/647297, PMID 8727617.
Dutka Malen S, Blaimont B, Wauters G, Courvalin P. Emergence of high-level resistance to glycopeptides in Enterococcus gallinarum and Enterococcus casseliflavus. Antimicrob Agents Chemother. 1994 Jul;38(7):1675-7. doi: 10.1128/AAC.38.7.1675, PMID 7979308.
Edmond MB, Ober JF, Weinbaum DL, Pfaller MA, Hwang T, Sanford MD. Vancomycin-resistant enterococcus faecium bacteremia: risk factors for infection. Clin Infect Dis. 1995 May 1;20(5):1126-33. doi: 10.1093/clinids/20.5.1126, PMID 7619987.
Ena J, Dick RW, Jones RN, Wenzel RP. The epidemiology of intravenous vancomycin usage in a university hospital. A 10-year study. JAMA. 1993 Feb 3;269(5):598-602. doi: 10.1001/jama.1993.03500050076029, PMID 8240468.
Frieden TR, Munsiff SS, Low DE, Willey BM, Williams G, Faur Y. Emergence of vancomycin-resistant enterococci in New York City. Lancet. 1993 Jul 10;342(8863):76-9. doi: 10.1016/0140-6736(93)91285-t, PMID 8100912.
Gould FK, Freeman R. Nosocomial infection with microsphere beds. Lancet. 1993 Jul 24;342(8865):241-2. doi: 10.1016/0140-6736(93)92333-o, PMID 8100961.
Handwerger S, Raucher B, Altarac D, Monka J, Marchione S, Singh KV. Nosocomial outbreak due to Enterococcus faecium highly resistant to vancomycin, penicillin, and gentamicin. Clin Infect Dis. 1993 Jun 1;16(6):750-5. doi: 10.1093/clind/16.6.750, PMID 8329505.
Handwerger S, Skoble J, Discotto LF, Pucci MJ. Heterogeneity of the van a gene cluster in clinical isolates of Enterococci from the northeastern United States. Antimicrob Agents Chemother. 1995 Feb;39(2):362-8. doi: 10.1128/AAC.39.2.362, PMID 7726499.
Heaton MP, Discotto LF, Pucci MJ, Handwerger S. Mobilization of vancomycin resistance by transposon-mediated fusion of a VanA plasmid with an Enterococcus faecium sex pheromone-response plasmid. Gene. 1996 Jan 1;171(1):9-17. doi: 10.1016/0378-1119(96)00022-4, PMID 8675038.
Karanfil LV, Murphy M, Josephson A, Gaynes R, Mandel L, Hill BC. A cluster of vancomycin-resistant Enterococcus faecium in an intensive care unit. Infect Control Hosp Epidemiol. 1992 Apr;13(4):195-200. doi: 10.1086/646509, PMID 1593099.
Kearns AM, Freeman R, Lightfoot NF. Nosocomial Enterococci: resistance to heat and sodium hypochlorite. J Hosp Infect. 1995 Jul 1;30(3):193-9. doi: 10.1016/s0195-6701(95)90314-3, PMID 8522775.
Livornese Jr LL, Dias S, Samel C, Romanowski B, Taylor S, May P. Hospital-acquired infection with vancomycin-resistant Enterococcus faecium transmitted by electronic thermometers. Ann Intern Med. 1992 Jul 15;117(2):112-6. doi: 10.7326/0003-4819-117-2-112, PMID 1605425.
Montecalvo MA, Horowitz H, Wormser GP, Seiter K, Carbonaro CA. Effect of novobiocin-containing antimicrobial regimens on infection and colonization with vancomycin-resistant Enterococcus faecium. Antimicrob Agents Chemother. 1995 Mar;39(3):794. doi: 10.1128/AAC.39.3.794, PMID 7793898.
Morris JG, Shay DK, Hebden JN, McCarter RJ, Perdue BE, Jarvis W. Enterococci resistant to multiple antimicrobial agents, including vancomycin. Establishment of endemicity in a university medical center. Ann Intern Med. 1995 Aug 15;123(4):250-9. doi: 10.7326/0003-4819-123-4-199508150-00002, PMID 7611590.
O’Donovan CA, Fan Havard P, Tecson Tumang FT, Smith SM, Eng RH. Enteric eradication of vancomycin-resistant enterococcus faecium with oral bacitracin. Diagn Microbiol Infect Dis. 1994 Feb 1;18(2):105-9. doi: 10.1016/0732-8893(94)90074-4, PMID 8062527.
Quintiliani Jr R, Evers S, Courvalin P. The vanB gene confers various levels of self-transferable resistance to vancomycin in enterococci. J Infect Dis. 1993 May 1;167(5):1220-3. doi: 10.1093/infdis/167.5.1220, PMID 8486958.
Rhinehart E, Smith NE, Wennersten C, Gorss E, Freeman J, Eliopoulos GM. Rapid dissemination of β-lactamase–producing, aminoglycoside-resistant Enterococcus faecalis among patients and staff on an infant–toddler surgical ward. N Engl J Med. 1990 Dec 27;323(26):1814-8. doi: 10.1056/NEJM199012273232606, PMID 2123301.
Rubin LG, Tucci V, Cercenado E, Eliopoulos G, Isenberg HD. Vancomycin-resistant Enterococcus faecium in hospitalized children. Infect Control Hosp Epidemiol. 1992 Dec;13(12):700-5. doi: 10.1086/648342, PMID 1289397.
Shay DK, Maloney SA, Montecalvo M, Banerjee S, Wormser GP, Arduino MJ. Epidemiology and mortality risk of vancomycin-resistant enterococcal bloodstream infections. J Infect Dis. 1995 Oct 1;172(4):993-1000. doi: 10.1093/infdis/172.4.993, PMID 7561221.
Thal LA, Chow JW, Mahayni R, Bonilla H, Perri MB, Donabedian SA. Characterization of antimicrobial resistance in Enterococci of animal origin. Antimicrob Agents Chemother. 1995 Sep;39(9):2112-5. doi: 10.1128/AAC.39.9.2112, PMID 8540725.
Wells CL, Juni BA, Cameron SB, Mason KR, Dunn DL, Ferrieri P. Stool carriage, clinical isolation, and mortality during an outbreak of vancomycin-resistant Enterococci in hospitalized medical and/or surgical patients. Clin Infect Dis. 1995 Jul 1;21(1):45-50. doi: 10.1093/clinids/21.1.45.
Zervos MJ, Kauffman CA, Therasse PM, Bergman AG, Mikesell TS, Schaberg DR. Nosocomial infection by gentamicin-resistant streptococcus faecalis. An epidemiologic study. Ann Intern Med. 1987;106(5):687-91. doi: 10.7326/0003-4819-106-5-687. PMID 3105375.
Falcone M, Russo A, Venditti M. Optimizing antibiotic therapy of bacteremia and endocarditis due to Staphylococci and Enterococci: new insights and evidence from the literature. J Infect Chemother. 2015 May 1;21(5):330-9. doi: 10.1016/j.jiac.2015.02.012, PMID 25813608.
Leclercq R, Derlot E, Duval J, Courvalin P. Plasmid-mediated resistance to vancomycin and teicoplanin in Enterococcus faecium. N Engl J Med. 1988;319(3):157-61. doi: 10.1056/NEJM198807213190307, PMID 2968517.
Ronald A. The etiology of urinary tract infection: traditional and emerging pathogens. The American Journal of Medicine. 2002 Jul 8;113(1)Suppl 1A:1414S-9S. doi: 10.1016/s0002-9343(02)01055-0, PMID 12113867.
Barros M, Martinelli R, Rocha H. Enterococcal urinary tract infections in a university hospital: clinical studies. Brazilian Journal of Infectious Diseases. 2009 Aug; 13(4):294-6. doi: 10.1590/s1413-86702009000400011, PMID 20231994.
Zhang Y, Du M, Chang Y, Chen LA, Zhang Q. Incidence, clinical characteristics, and outcomes of nosocomial Enterococcus spp. bloodstream infections in a tertiary-care hospital in Beijing, China: a four-year retrospective study. Antimicrobial Resistance and Infection Control. 2017 Dec;6(1):1-173. doi: 10.1186/s13756-017-0231-y, PMID 28680588.
Khan HA, Ahmad A, Mehboob R. Nosocomial infections and their control strategies. Asian Pacific Journal Trop Biomedicine. 2015 Jul 1;5(7):509-14. doi: 10.1016/j.apjtb.2015.05.001.
Jahan M, Holley RA. Incidence of virulence factors in enterococci from raw and fermented meat and biofilm forming capacity at 25 °C and 37 °C. International J of Food Microbiology. 2014 Jan 17;170:65-9. doi: 10.1016/j.ijfoodmicro.2013.11.002, PMID 24291183.
Rao K, Deepa S, Venkatesha D. Enterococci: A journey of a successful pathogen. International Archives of Integrated Medicine. 2014 Dec;1(4):49-57.
Naik TB, Lavanya J, Mane V, Upadhya AK. Enterococci speciation and antibiogram: an assessment of data at a tertiary care hospital in Karnataka. Indian J Microbiol Res. 2016;3(2):130-5.
Tellis R, Muralidharan SS M. A prospective study of antibiotic resistance and virulence factors in Enterococci isolated from patients with end stage renal disease. International Journal of Biol Medical Research. 2012;3(3):174-80. doi: 10.7439/ijbr.v3i3.330.
Cetinkaya Y, Falk P, Mayhall CG. Vancomycin-resistant Eenterococci. Clinical Microbiology Reviews. 2000 Oct 1;13(4):686-707. doi: 10.1128/CMR.13.4.686, PMID 11023964.
Sivaradjy M, Gunalan A, Priyadarshi K, Madigubba H, Rajshekar D, Sastry AS. Increasing trend of vancomycin-resistant enterococci bacteremia in a tertiary care hospital of South India: A three-year prospective study. Indian Journal of Critical Care Medicine: Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine. Indian J Crit Care Med. 2021 Aug;25(8):881-5. doi: 10.5005/jp-journals-10071-23916, PMID 34733028.
Wavare Sanjay M, Sajjan GM. Study of vancomycin resistant enterococci isolated from urinary tract infections. Int J Pharm Pharm Sci. 2015;7(5):337-9.
Bin Asif H, Ali SA. The genus enterococcus and its associated virulent factors. Microorganisms. 2019 Oct 29:109-30.
Kirst HA, Thompson DG, Nicas TI. Historical yearly usage of vancomycin. Antimicrobial Agents and Chemotherapy. 1998 May 1;42(5):1303-4. doi: 10.1128/AAC.42.5.1303, PMID 9593175.
Published
How to Cite
Issue
Section
Copyright (c) 2023 ARPITHA P. M., RAKSHITHA RANI N., SUMANA K.
This work is licensed under a Creative Commons Attribution 4.0 International License.
