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Volume 26, Issue 3

Original Article

The Investigation of the In Vitro Resistance to the Antibiotics Used in Therapy of Enterococci Isolated From Clinical Specimens

Dilek Bilici
Affiliations
  • Atatürk Üniversitesi, Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı, Erzurum, Türkiye
,
Osman Aktaş
Affiliations
  • Atatürk Üniversitesi, Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı, Erzurum, Türkiye
,
Ahmet Özbek
Affiliations
  • Atatürk Üniversitesi, Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı, Erzurum, Türkiye
,
Sefa Bilici
Affiliations
  • Atatürk Üniversitesi, Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı, Erzurum, Türkiye
  • Daptomycin
  • Enterococcus
  • highlevel aminoglycoside resistance
  • quinupristindalfopristin
  • tigecycline
  • Vancomycinresistant enterococci

Abstract

Objective: The purpose of this study is to investigate the sensitivity of enterococci isolated from infections in our region against daptomycin, tigecycline, quinupristin/dalfopristin and other antibiotics used in conventional treatment.

Methods: Enterococcal species isolated from clinical specimens were identified by API® 20 Strep (bioMérieux, France) test kits. Antibiotic susceptibility testing of isolates was carried out according to the recommendations in Clinical and Laboratory Standards Institute (CLSI) document M100-S20. High-level aminoglycoside resistance was investigated by gentamicin (120 mg), and streptomycin (300 mg) disks and minimum inhibitory concentrations (MICs) to tigecycline and daptomycin were determined by the E-test® (AB Biodisk, Sweden) method.

Results: A total of 98 enterococcal strains (55 Enterococcus faecium, 40 E. faecalis, 2 E. durans and 1 E. avium) have been identified. Fifty-nine (60%) of the strains were isolated from urine and the rest from blood, wounds, cerebrospinal fluid and vaginal samples. Isolation rate of E. faecium is significantly higher than E. faecalis in hospitalized patients. All strains were sensitive to linezolid and 3 (5.5%) isolates of E. faecium were resistant to both vancomycin and teicoplanin. The resistance of E. faecalis and E. faecium to penicillin and ampicillin were 10 (25%)/52 (94.5%) and 4 (10%)/51 (92.7%), respectively. High-level gentamicin/streptomycin resistance was found much higher in E. faecium (69.1%/43.6%) than E. faecalis (25%/27.5%) isolates. The MIC ranges for tigecycline were 0.023-3 µg/ml and 0.016-3 µg/ml for daptomycin.

Conclusions: E. faecium was the most prevalent species isolated  in hospitalized patients. Vancomycin resistance was low, but prevalence of the high-level aminoglycoside resistance and the resistance to antibiotics was high in these isolates. Rapid diagnosis of enterococci and determination of their antibiotic susceptibilities is important for implementation of appropriate treatment and management of infected patients with resistant strains. 

  • 102-107
  • 10.5152/kd.2013.30
  • July 23, 2019
  • 1898
  • 661
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  • This work is licensed under a Creative Commons Attribution-Non Commercial 4.0 International License. CC BY-NC
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