Analysis of biofilm production in Enterococcus faecium strains depending on clinical source

Purpose: Enterococcus faecium strains have been reported worldwide as etiologic factors of many nosocomial infections, which are difficult to manage because of the constantly increasing resistance of these microorganisms to antibiotics and the ability to form biofilm. The aim of this study was to analyze the ability to produce a biofilm in E. faecium strains, depending on the patient’s clinical material. Materials and methods: Sixty-six E. faecium strains were investigated. Identification and susceptibility testing were conducted by the VITEK2 system. The ability to form biofilm was assessed by phenotypic methods. The presence of selected virulence genes was established by PCR followed by gel electrophoresis and sequencing. Results: Among the tested E. faecium isolates, 72.7% were biofilm-positive (BIO+) and 27.3% biofilm-negative (BIO-). Strains were collected mostly from rectal swabs (30.4%) and blood (18.3%). BIO+ strains from infections constituted 31.8% (52.4% isolated from blood) and from colonization 40.9% (48.2% from rectal swabs). 91.7% of the Blood Group strains and 68.5% of the Other Group strains produced biofilm. Strains from the Colonization Group produced biofilm in a proportion similar to the Infection Group (about 75%). There were no statistically significant differences in virulence and resistance, except for vancomycin (more resistant BIO+ Other than the BIO+ Blood Group, and more resistant BIO+ Colonization than BIO+ Infection Group) and teicoplanin (more resistant BIO+ Colonization than the BIO+ Infection Group). Conclusion: The majority of E. faecium isolates carries high levels of resistance to many antimicrobials, is well equipped with virulence genes, and possesses the ability to form biofilm

Occurrence of high-level aminoglycoside resistance (HLAR) among Enterococcus species strains

Purpose: Today, Enterococcus species are one of the most frequent etiological agents in nosocomial infections. The aim of this study was to determine the susceptibility to antibiotics and the prevalence of high-level aminoglycoside resistance (HLAR) among Enterococcus strains. Materials and methods: The susceptibility of 85 isolates of Enterococcus (47 E. faecalis and 38 E. faecium) was determined using the disk diffusion method. The results were interpreted according to European Committee on Antimicrobial Suscepti-bility Testing (EUCAST) guidelines. PASW Statistics 17.0 was used for statistical analysis. Results: E. faecalis strains showed the highest susceptibility to ampicillin, tigecycline, vanco-mycin, imipenem, and linezolid and E. faecium to linezolid, tigecycline, and quinupristin/dalfopristin. Among all tested strains, high-level gentamicin resistance (HLGR) was found in 4% of E. faecalis and 8% of E. faecium strains, high-level strepto-mycin resistance (HLSR) in 45% and 42%, and HLAR in 50% and 32% of strains, respectively. HLGR was detected only in vancomycin-resistant Enterococcus (VRE)− strains (12%), while HLSR in 76.9% of VRE+ and 24% of VRE− strains, and HLAR in 23.1% of VRE+ and 64% of VRE− strains. The tested strains were also divided into two groups: HLSR+ and HLAR+. In both groups, statistically significant susceptibility differences (p<0.05) were found for ampicillin, imipenem and trimethoprim/sulfamethoxazole. The most frequent antibiotic resistance profile among E. faecalis strains was SR (resistance phenotype to strepto-mycin), and among E. faecium, AMPR, IMPR, CNR, SR, SXTR (ampicillin, imipenem, gentamicin, streptomycin, trimethoprim/sulfamethoxazole). Conclusions: This study showed the slowly increasing prevalence of HLAR and resistance to newer antibiotics (linezolid and tigecycline) among Enterococcus strains. It is necessary to search for new directions in the treatment of enterococcal infections