Multidrug-resistant enterococci in the hospital environment: detection of novel vancomycin-resistant E. faecium clone ST910

  • Raoudha Dziri Faculty of Sciences of Tunis, University of Tunis El Manar, Tunis, Tunisia
  • Carmen Lozano University of La Rioja, Logroño, Spain
  • Leila Ben Said Faculty of Sciences of Tunis, University of Tunis El Manar, Tunis, Tunisia
  • Ridha Bellaaj Military Hospital of Tunis HMPIT Tunis, Tunisia
  • Abdellatif Boudabous Faculty of Sciences of Tunis, University of Tunis El Manar, Tunis, Tunisia
  • Karim Ben Slama Faculty of Sciences of Tunis, University of Tunis El Manar, Tunis, Tunisia
  • Carmen Torres University of La Rioja, Logroño, Spain
  • Naouel Klibi Faculty of Sciences of Tunis, University of Tunis El Manar, Tunis, Tunisia
Keywords: Enterococcus, hospital environment, VRE, ST910, cross-contamination, Tunisia

Abstract

Introduction: The role of the hospital environment as a reservoir of resistant bacteria in Tunisia has been poorly investigated; however, it could be responsible for the transmission of multidrug-resistant bacteria. The objective was to study the prevalence of Enterococcus in the environment of a Tunisian hospital and the antibiotic resistance phenotype/genotype in recovered isolates, with special reference to vancomycin resistance.

Methodology: A total of 300 samples were taken (March–June, 2013) and inoculated in Slanetz-Bartley agar plates supplemented or not supplemented with 8 µg/mL of vancomycin. Antibiotic resistance genes were tested by polymerase chain reaction (PCR). The clonal relatedness of the vanA isolates was assessed using pulsed-field gel electrophoresis (PFGE) and multilocus sequence testing (MLST).

Results: Enterococci were recovered in 33.3% of tested samples inoculated in SB medium. E faecium was the most prevalent species, followed by E. faecalis and E. casseliflavus. Antimicrobial resistance genes detected were as follows (number of isolates): erm(B) (71), tet(M) (18), aph(3’)-IIIa (27), ant(6)-Ia (15), cat(A) (4), and van(C2) (6). Vancomycin-resistant-enterococci (VRE) were recovered from 14 samples (4.7%), when tested in SB-VAN. The 14 VRE (one per positive sample) were identified as E. faecium and contained the van(A),erm(B), tet(M), ant(6)-Ia, and aph(3’)-IIIa genes. Thirteen of the VRE strains were ascribed by PFGE and MLST to a novel clone (new ST910), and only one VRE strain was typed as ST80 included in CC17.

Conclusions: The emergence and spread of new clones of VRE, especially in the hospital environment in this country, could become particularly problematic.

Author Biographies

Raoudha Dziri, Faculty of Sciences of Tunis, University of Tunis El Manar, Tunis, Tunisia
Department of Biology
Carmen Lozano, University of La Rioja, Logroño, Spain
Área de Bioquímica y Biología Molecular
Leila Ben Said, Faculty of Sciences of Tunis, University of Tunis El Manar, Tunis, Tunisia
Department of Biology
Ridha Bellaaj, Military Hospital of Tunis HMPIT Tunis, Tunisia
Service d’hygiène hospitalière et de protection de l’environnement
Abdellatif Boudabous, Faculty of Sciences of Tunis, University of Tunis El Manar, Tunis, Tunisia
Department of Biology
Karim Ben Slama, Faculty of Sciences of Tunis, University of Tunis El Manar, Tunis, Tunisia
Department of Biology
Carmen Torres, University of La Rioja, Logroño, Spain
Área de Bioquímica y Biología Molecular
Naouel Klibi, Faculty of Sciences of Tunis, University of Tunis El Manar, Tunis, Tunisia
Department of Biology
Published
2016-08-31
How to Cite
1.
Dziri R, Lozano C, Ben Said L, Bellaaj R, Boudabous A, Ben Slama K, Torres C, Klibi N (2016) Multidrug-resistant enterococci in the hospital environment: detection of novel vancomycin-resistant E. faecium clone ST910. J Infect Dev Ctries 10:799-806. doi: 10.3855/jidc.8014
Section
Original Articles