Isolation of vanA-Mediated Vancomycin-Resistant Enterococcus faecalis (ST1912/CC116) and Enterococcus faecium (ST80/CC17), optrA-Positive Linezolid-Resistant E. faecalis (ST32, ST1902) from Human Clinical Specimens in Bangladesh.

BACKGROUND/

OBJECTIVES

Enterococcus is one of the major nosocomial pathogens. The present status of antimicrobial resistance determinants and virulence factors was analyzed for current Enterococcus causing infectious diseases in Bangladesh.

METHODS

Clinical isolates of Enterococcus recovered from various specimens in a tertiary care hospital were analyzed. Antimicrobial susceptibility was measured by a broth microdilution test, and resistance genes/virulence factors were detected by uniplex/multiplex PCR, along with sequencing analysis as required. The sequence type (ST) of E. faecalis and E. faecium was identified based on a multilocus sequence typing (MLST) scheme.

RESULTS

For a one-year period, a total of 143 isolates (135 E. faecalis, 7 E. faecium, and 1 E. hirae) were collected. Although all E. faecalis isolates were susceptible to penicillin, high resistance rates were noted against erythromycin (87%) and levofloxacin (62%). High-level resistance to gentamicin was detected in 30% of E. faecalis and 86% of E. faecium. Vancomycin resistance due to vanA was identified in one isolate each of E. faecalis (ST1912, CC116) and E. faecium (ST80, CC17). Three E. faecalis isolates (2.2%) with ST32 or ST1902 were resistant to linezolid, harboring optrA-fexA.

CONCLUSIONS

The present study identifies the vancomycin-resistant Enterococcus harboring vanA from humans in Bangladesh and shows the potential spread of optrA in multiple lineages of E. faecalis.