Australian Group on Antimicrobial Resistance Enterococcus Surveillance Programme annual report, 2010
DOI:
https://doi.org/10.33321/cdi.2013.37.31Keywords:
antimicrobial resistance surveillance, Enterococcus faecium, Enterococcus faecalis, vancomycin resistant enterococcusAbstract
In 2010, 15 institutions around Australia conducted a period prevalence study of key resistances in isolates of Enterococcus species associated with a range of clinical disease amongst in- and outpatients. Each institution collected up to 100 consecutive isolates and tested these for susceptibility to commonly used antimicrobials using standardised methods. Vancomycin-resistant Enterococcus faecium and Enterococcus faecalis were characterised by pulsed-field gel electrophoresis. Multilocus sequence typing was performed on representative pulsotypes of E. faecium. Susceptibility results were compared with similar surveys conducted in 1995, 1999, 2003, 2005, 2007 and 2009. In the 2010 survey, E. faecalis (1,201 isolates) and E. faecium (170 isolates) made up 98.9% of the 1,386 isolates tested. Ampicillin resistance was very common (85.3%) in E. faecium and absent in E. faecalis. Non-susceptibility to vancomycin was 36.5% in E. faecium (similar to the 35.2% in 2009 but up from 15.4% in the 2007 survey) and 0.5% in E. faecalis. There were significant differences in the proportion of vancomycin-resistant E. faecium between the states ranging from 0% in Western Australia to 54.4% in South Australia. The vanB gene was detected in 62 E. faecium and 3 E. faecalis isolates. The vanA gene was detected in 1 E. faecium isolate. All vancomycin-resistant E. faecium belonged to clonal complex 17. The most common sequence type (ST) was ST203, which was found in all regions that had reports of vancomycin resistant enterococci. ST341 was detected only in New South Wales/Australian Capital Territory and ST414 only in South Australia and Victoria. High-level resistance to gentamicin was 34.1% in E. faecalis and 66.1% in E. faecium. A subset of isolates was tested against high-level streptomycin, linezolid and quinupristin/dalfopristin. High-level streptomycin resistance was found in 8.2% of E. faecalis isolates and 43.8% of E. faecium isolates. Linezolid non-susceptibility was more common in E. faecalis (5.8%) than E. faecium (0.9%). Overall 9.4% of E. faecium were resistant to quinupristin/dalfopristin (E. faecalis is intrinsically resistant). Commun Dis Intell 2013;37(3):E199–E209.
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References
Leclercq R, Derlot E, Duval J, Courvalin P. Plasmid-mediated resistance to vancomycin and teicoplanin in Enterococcus faecium. N Engl J Med 1988;319(3):157–161.
Frieden TR, Munsiff SS, Low DE, Willey BM, Williams G, Faur Y, et al. Emergence of vancomycin-resistant enterococci in New York City. Lancet 1993;342(8863):76–79.
Kamarulzaman A TFA, Boquest AL, Geddes JE, Richards MJ. Vancomycin-resistant Enterococcus faecium in a liver transplant recipient. Proceedings of the Annual Scientific Meeting of the Australasian Society for Infectious Diseases. Aust N Z J Med 1995;25(5):560 [Abstract].
Bell J, Turnidge J, Coombs G, O’Brien F. Emergence and epidemiology of vancomycin-resistant enterococci in Australia. Commun Dis Intell 1998;22(11):249–252.
Valdezate S, Miranda C, Navarro A, Freitas AR, Cabrera JJ, Carrasco G, et al. Clonal outbreak of ST17 multidrug-resistant Enterococcus faecium harbouring an Inc18-like::Tn1546 plasmid in a haemo-oncology ward of a Spanish hospital. J Antimicrob Chemother 2012;67(4):832–836.
Palazzo IC, Pitondo-Silva A, Levy CE, da Costa Darini AL. Changes in vancomycin-resistant Enterococcus faecium causing outbreaks in Brazil. J Hosp Infect 2011;79(1):70–74.
Xu HT, Tian R, Chen DK, Xiao F, Nie ZY, Hu YJ, et al. Nosocomial spread of hospital-adapted CC17 vancomycin-resistant Enterococcus faecium in a tertiary-care hospital of Beijing, China. Chin Med J 2011;124(4):498–503.
Werner G, Fleige C, Ewert B, Laverde-Gomez JA, Klare I, et al. High-level ciprofloxacin resistance among hospital-adapted Enterococcus faecium (CC17). Inter J Antimicrob Agents 2010;35(2):119–125.
Johnson PD, Ballard SA, Grabsch EA, Stinear TP, Seemann T, Young HL, et al. A sustained hospital outbreak of vancomycin-resistant Enterococcus faecium bacteremia due to emergence of vanB E. faecium sequence type 203. J Infect Dis 2010;202(8):1278–1286.
Christiansen KJ, Tibbett PA, Beresford W, Pearman JW, Lee RC, Coombs GW, et al. Eradication of a large outbreak of a single strain of vanB vancomycin-resistant Enterococcus faecium at a major Australian teaching hospital. Infect Control Hosp Epidemiol 2004;25(5):384–390.
Cooper E, Paull A, O’Reilly M. Characteristics of a large cluster of vancomycin-resistant enterococci in an Australian hospital. Infect Control Hosp Epidemiol 2002;23(3):151–153.
Bartley PB, Schooneveldt JM, Looke DF, Morton A, Johnson DW, Nimmo GR. The relationship of a clonal outbreak of Enterococcus faecium vanA to methicillin-resistant Staphylococcus aureus incidence in an Australian hospital. J Hosp Infect 2001;48(1):43–54.
MacIntyre CR, Empson M, Boardman C, Sindhusake D, Lokan J, Brown GV. Risk factors for colonization with vancomycin-resistant enterococci in a Melbourne hospital. Infect Control Hosp Epidemiol 2001;22(10):624–629.
Joels CS, Matthews BD, Sigmon LB, Hasan R, Lohr CE, Kercher KW, et al. Clinical characteristics and outcomes of surgical patients with vancomycin-resistant enterococcal infections. Amer Surg 2003;69(6):514–519.
DiazGranados CA, Zimmer SM, Klein M, Jernigan JA. Comparison of mortality associated with vancomycin-resistant and vancomycin-susceptible enterococcal bloodstream infections: a meta-analysis. Clin Infect Dis 2005;41(3):327–333.
Kamboj M, Cohen N, Gilhuley K, Babady NE, Seo SK, Sepkowitz KA. Emergence of daptomycin-resistant VRE: experience of a single institution. Infect Control Hosp Epidemiol 2011;32(4):391–394.
Schulte B, Heininger A, Autenrieth IB, Wolz C. Emergence of increasing linezolid-resistance in enterococci in a post-outbreak situation with vancomycin-resistant Enterococcus faecium. Epidemiol Infect 2008;136(8):1131–1133.
Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. Twenty-second informational supplement M100-S22. Villanova, PA, USA 2012.
Kulski JK, Wilson RD, Bending R, Grubb W. Antibiotic resistance and genomic analysis of enterococci in an intensive care unit and general wards. Pathology 1998;30(1):68–72.
Homan WL, Tribe D, Poznanski S, Li M, Hogg G, Spalburg E, et al. Multilocus sequence typing scheme for Enterococcus faecium. J Clin Microbiol 2002;40(6):1963–1971.
McAlister T, George N, Faoagali J, Bell J. Isolation of beta-lactamase positive vancomycin resistant Enterococcus faecalis; first case in Australia. Commun Dis Intell 1999;23(9):237–239.
Bell JM, Paton JC, Turnidge J. Emergence of vancomycin-resistant enterococci in Australia: phenotypic and genotypic characteristics of isolates. J Clin Microbiol 1998;36(8):2187–2190.
Cheng VC, Tai JW, Ng ML, Chan JF, Wong SC, Li IW, et al. Extensive contact tracing and screening to control the spread of vancomycin-resistant Enterococcus faecium ST414 in Hong Kong. Chin Med J 2012;125(19):3450–3457.
Lu CL, Chuang YC, Chang HC, Chen YC, Wang JT, Chang SC. Microbiological and clinical characteristics of vancomycin-resistant Enterococcus faecium bacteraemia in Taiwan: implication of sequence type for prognosis. J Antimicrob Chemother 2012;67(9):2243–2249.
Fournier S, Brossier F, Fortineau N, Gillaizeau F, Akpabie A, Aubry A, et al. Long-term control of vancomycin-resistant Enterococcus faecium at the scale of a large multihospital institution: a seven-year experience. Euro Surveill 2012;17(6):pii 20229.
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