Analysis Of Selected Genetic Traits, Phenotypes, And The Epidemiological Threat Of Enterococcus Bacteria Resistant To Vancomycin
, and | Jun 10, 2019
About this article
Article Category: article
Published Online: Jun 10, 2019
Page range: 35 - 48
Received: Jan 01, 2018
Accepted: Nov 01, 2018
DOI: https://doi.org/10.21307/PM-2019.58.1.035
© 2019 Wojciech Rogóż et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Fig. 1.
![The scheme of the gene cluster structure determining phenotypes VanA, VanB, VanD, VanG i VanM (based on [41, 47, 49, 52]).](https://sciendo-parsed.s3.eu-central-1.amazonaws.com/6470921571e4585e08aa02ca/j_PM-2019.58.1.035_fig_001.jpg?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20240530T080156Z&X-Amz-SignedHeaders=host&X-Amz-Expires=18000&X-Amz-Credential=AKIA6AP2G7AKP25APDM2%2F20240530%2Feu-central-1%2Fs3%2Faws4_request&X-Amz-Signature=0bf2f20fa85e41e4b11bde995b53f9ec6fd051166ac6301736a68862da242d5b)
Fig. 2.
![Vancomycin resistance among E. faecium and E. faecalis strains isolated from blood samples of the Polish patients between 2010 and 2015 [67].](https://sciendo-parsed.s3.eu-central-1.amazonaws.com/6470921571e4585e08aa02ca/j_PM-2019.58.1.035_fig_002.jpg?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20240530T080156Z&X-Amz-SignedHeaders=host&X-Amz-Expires=18000&X-Amz-Credential=AKIA6AP2G7AKP25APDM2%2F20240530%2Feu-central-1%2Fs3%2Faws4_request&X-Amz-Signature=3470b1fabb7d8a1632bb0d1714a4acd142203db8f657424ceaa39d959cee9f95)
Characterization of vancomycin-resistant Enterococcus phenotypes
| Phenotype | Vancomycin MIC (mg/L) | Teicoplanin MIC (mg/L) | Modification | Localization | Transfer capibility | Expression | Major species |
|---|---|---|---|---|---|---|---|
| VanA | 64–1000 | 16–512 | d-Ala-d-Lac | Plasmid or chromosome | yes | induced |
|
| VanB | 4–1000 | 0.5–1 | d-Ala-d-Lac | Plasmid or chromosome | yes | induced |
|
| VanC | 2–32 | 0.5–1 | d-Ala-d-Ser | chromosome | no | Constitutive or induced |
|
| VanD | 64–128 | 4–64 | d-Ala-d-Lac | Plasmid or chromosome | no | Constitutive or induced |
|
| VanE | 8–32 | 0.5 | d-Ala-d-Ser | chromosome | no | induced |
|
| VanG | ≤ 16 | wrażliwy | d-Ala-d-Ser | chromosome | yes | induced |
|
| VanL | 8 | ≤ 0.5 | d-Ala-d-Ser | chromosome | no | induced |
|
| VanM | > 256 | 96 | d-Ala-d-Lac | Plasmid or chromosome | yes | induced |
|
| VanN | 16 | ≤ 0.5 | d-Ala-d-Ser | plasmid | yes | constitutive |
|
Percentages of vancomycin-resistant Enterococcus faecium isolates in the European countries between 2012 and 2015 (data according to [77])
| Percentages of vancomycin-resistant |
2012 | 2015 |
|---|---|---|
| Below 1% | Iceland, Norway, Sweden, Finland, Estonia, the Netherlands, France, Slovenia, Croatia, Bulgaria | Iceland, Norway, Sweden, Finland, Estonia, France, Belgium |
| 1–5% | Spain, Belgium, Denmark, Austria, Slovakia, Hungary, Romania | Spain, Denmark, the Netherlands, Austria, Slovenia |
| 5–10% | Latvia, Lithuania, Poland, Italy | Czechia (Czech Republic) |
| 10–25% | Great Britain, Portugal, Germany, Czechia (Czech Republic), Greece, Cyprus | Great Britain, Portugal, Germany, Poland, Latvia, Lithuania, Slovakia, Hungary, Italy, Bulgaria, Greece |
| 25–50% | Ireland | Ireland, Croatia, Romania, Cyprus |
| over 50% | – | – |
The specification of VRE isolates number and the percentages of all alarming factors at 195 Polish hospitals between 2012 and 2016 (data according to [71])
| Year | No. of isolates | Percentage of all alarming factors |
|---|---|---|
| 2016 | 50 | 1.14% |
| 2015 | 34 | 0.81% |
| 2014 | No data | No data |
| 2013 | 18 | 0.44% |
| 2012 | 11 | 0.33% |
Resistance to the selected antibiotics of VRE isolates collected from 7 different hospitals
| Enterococci strains | Drug used | MIC (μg/ml) | % of resistant isolates | |
|---|---|---|---|---|
| 50% | 90% | |||
| VanA and VanB strains | Daptomycin | 4 | 8 | Not determined |
| Linezolid | 2 | 2 | 1.5 | |
| Quinupristin/dalfopristin | 0.5 | 1 | 6.0 | |
| Ampicillin | 64 | 128 | 93.2 | |
| Doxycycline | 4 | 16 | 14.2 | |
| Vancomycin | > 128 | > 128 | 100 | |
| VanC1 and VanC2 strains | Daptomycin | 1 | 2 | Not determined |
| Linezolid | 2 | 2 | 0 | |
| Quinupristin/dalfopristin | 2 | 2 | 0 | |
| Ampicillin | 0.5 | 1 | 0 | |
| Doxycycline | ≤ 0.25 | ≤ 0.25 | 4.5 | |
| Vancomycin | 4 | 4 | 0 | |