African health sciences · 2026
Enterococcus faecium multicenter antimicrobial resistance surveillance in Tunisia (2010-2022): high vancomycin resistance rates and linezolid resistance emergence.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Raddaoui Anis, Moussa Mouna Louisa Ben, Chebbi Yosra, Frigui Siwar, Bougharriou Sadok, Kanzari Lamia, Meftah Khaoula, Battikh Hajer, Haddad Ons, Dhraief Sarra, Kaoual Salma, Maatouk Yassmine, Dhaou Khouloud Ben, Hamdoun Manel, Mezghani Senda, Mahjoubi Faouzia, Kadri Yosr, Marzouk M, Ghariani A, Barguellil Farouk, Bahri Olfa, Boukadida Jalel, Hannachi Neila, Besbes Sophia, Thabet Lamia, Mastouri Maha, Zribi Meriem, Smaoui Hanen, Slim Leila, Mhiri Emna, Boubaker Ilhem Boutiba-Ben, Hammami Adnene, Karray Hela, Ouhichi Ramzi, Achour Wafa
Аннотация
BACKGROUND: Vancomycin-resistant Enterococcus faecium is classified among World Health Organization priority pathogens for Research and development of new antibiotics. This study presents the results of 13-year surveillance of antibiotic resistance in E. faecium, with a specific focus on vancomycin and linezolid resistance in thirteen university hospitals across various regions of Tunisia.
METHODS: All participating laboratories followed a standardized methodology for clinical sample culture, bacterial identification, antibiotic susceptibility testing according to CA-SFM guidelines, result interpretation, epidemiological data collection. Additionally, they implemented quality controls.
FINDINGS: During the surveillance period, 2,931 E. faecium isolates were collected, predominantly from urine (49.1%) and blood cultures (24%), with high prevalence in Surgery Departments (30.3%) and Intensive Care Units (23.6%). Resistance rates were high for ampicillin (87.1%), erythromycin (93.6%), gentamicin (62.8%) and vancomycin (26%). Since 2019, six linezolid-resistant isolates have been isolated and only one isolate resistant to tigecycline was identified in 2021. Vancomycin resistance had significant upward trend since 2012, peaking at 38.1% in 2017. It was significantly associated to gentamicin (84.9% vs. 53.8%) (p<0.0001) and erythromycin95.8% vs. 89.6%) (p=0.0001) in a five year period (2018 - 2022).
CONCLUSION: This worrying situation requires deeper investigations to develop adapted strategies with targeted measures in high-risk departments.
METHODS: All participating laboratories followed a standardized methodology for clinical sample culture, bacterial identification, antibiotic susceptibility testing according to CA-SFM guidelines, result interpretation, epidemiological data collection. Additionally, they implemented quality controls.
FINDINGS: During the surveillance period, 2,931 E. faecium isolates were collected, predominantly from urine (49.1%) and blood cultures (24%), with high prevalence in Surgery Departments (30.3%) and Intensive Care Units (23.6%). Resistance rates were high for ampicillin (87.1%), erythromycin (93.6%), gentamicin (62.8%) and vancomycin (26%). Since 2019, six linezolid-resistant isolates have been isolated and only one isolate resistant to tigecycline was identified in 2021. Vancomycin resistance had significant upward trend since 2012, peaking at 38.1% in 2017. It was significantly associated to gentamicin (84.9% vs. 53.8%) (p<0.0001) and erythromycin95.8% vs. 89.6%) (p=0.0001) in a five year period (2018 - 2022).
CONCLUSION: This worrying situation requires deeper investigations to develop adapted strategies with targeted measures in high-risk departments.