JHSM
Journal of Health Sciences and Medicine

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Original Article
The change of antibiotic resistance rates over the years in Enterococcus spp. isolated from clinical specimens
Abstract
Aims: The aim of this study was to retrospectively evaluate the change in antibiotic resistance rates of Enterococcus species isolated from various clinical samples of outpatients and inpatients in our hospital over the years.
Methods: Between January 2018 and December 2021, various clinical samples sent to Tekirdağ Namık Kemal University Hospital Microbiology Laboratory from outpatients, inpatients and intensive care patients were retrospectively examined. The samples were inoculated on 5% sheep blood agar, chocolate agar and EMB agar media according to their types and incubated at 37°C. The blood cultures were performed by BACTEC 1280 System (Becton Dickinson, MA, USA). Bacterial identification and antimicrobial sensitivity tests were made using conventional methods and automated systems.
Results: A total of 417 Enterococcus strains were isolated in our laboratory at four years and included in the study. Of the 417 isolates, 204 (48.9%) were isolated from male patients and 213 (51.1%) from female patients. The mean age of the patients was 57.79±22.9 years (0-96 years). It was determined that 36.9% of the isolates belonged to outpatients, 33.4% to inpatients and 29.7% to intensive care unit patients. Of the 122 enterococci isolates identified as species, 49.2% were typed as Enterococcus faecalis (E. faecalis) and 40.2% as Enterococcus faecium (E. faecium). Of the 417 isolates, 60.4% were isolated from urine samples, 24.2% from blood samples, and 8.9% from wound samples. Considering the total antibiotic resistance rates; ampicillin was 34.9%, ciprofloxacin was 46.4%, vancomycin was 8.4%, tigecline was 3.2%, high-level gentamicin was 49.0%. Linezolid and nitrofurantoin resistance were not detected. Ampicillin and vancomycin resistance rates were determined to have a statistically significant increase within four years. Ampicillin, ciprofloxacin, vancomycin and high-level gentamicin resistance rates were found to be significantly higher in isolates obtained from inpatients and intensive care patients compared to enterococcal isolates obtained from outpatients.
Conclusion: In our study, it was determined that antibiotic resistance in enterococcal isolates, which are the causative agents of infection in our hospital, increased over the years. In this way, determining the change in antibiotic resistance rates is beneficial in determining appropriate antibiotic use policies. It is thought that conducting surveillance studies on antibiotic resistance periodically and taking new measures according to changing antibiotic resistance rates will be beneficial in terms of treatment.

Keywords : Enterococcus, antibiotic resistance, vancomycin, vancomycin resistant enterococci (VRE)

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1. Harvey RA (editors), Cornelissen CN, Fisher BD. Lippincott’sillustrated reviews: Microbiology. 3rd ed. Philadelphia: Williams &Wilkins; 2012:87-88.
2. Koneman EW, Allen SD, Janda WM, et al. (editors). Color Atlasand Textbook of Diagnostik Microbiology. Lippincott, 6th Edition,Philadelphia, Williams and Wilkins, 2005:700-711.
3. Mert-Dinc B, Aykut-Arca E, Yagcı S, Karabiber N. In-vitro antiboticsusceptibility of Enterococcus faecalis and Enterococcus faeciumstrains isolated from various clinical samples. Turk Hij Den BiyolDerg. 2009;66:117-121.
4. Altun D,Erdem G, Coplu N, Çagatay M. Investigation ofEnterococcus strains isolated from clinical materials to specieslevel and determination of antibiotic susceptibilities by variousmethods. ANKEM Derg. 2013;27:130-134.
5. Guckan R, Elmas A, Tilgel S, Yuksel G. Antimicrobial resistancerates of Enterococcus strains isolated from various clinicalspecimens. Int J Basic Clin Med. 2013;1:74-77.
6. Gözüböyük G, Uyanık MH, Hancı H, Aktaş O, Özbek A.Kan kültürlerinden izole edilen enterokokların antibiyotikduyarlılıkları. ANKEM Derg. 2013;27(3):107-112.
7. Kınıklı S, Cesur S, Hatipoğlu CA, et al. Vankomisine dirençlienterokokların saptanmasında iki farklı kromojenik besiyerininkarşılaştırılması. Turk J Clin Lab. 2019;10(3):319-323.
8. Odemiş I, Köse S, Ersan G, Celik D, Akbulut I. Hastanede yatanhastaların klinik örneklerinden izole edilen enterokok suşlarınınantibiyotik duyarlılıklarının değerlendirilmesi. Turk Hij Den BiyolDerg. 2018;75(4):345-352.
9. The European Committee on Antimicrobial SusceptibilityTesting. Breakpoint tables for interpretation of MICs and zonediameters, Version 10.0.2020. http://www.eucast.org. (erişimtarihi: 22.06.2022).
10. Gok ŞM, Türk Dagı H, Kara F, Arslan U, Fındık D. Investigationof antibiotic resistance and virulence factors of Enterococcusfaecium and Enterococcus faecalis strains isolated from clinicalsamples. Mikrobiyol Bul. 2020;54:26-39.
11. Aral M, Pakoz NIE, Aral I, Dogan S. Antibiotic resistanceof Enterococcus faecalis and Enterococcus faecium strainsisolated from various clinical samples. Türk Hij Den Biyol Derg.2011;68:85-92.
12. Alkan S, Kuloğlu F, Akata F. Enterokok bakteriyemilerinde riskfaktorlerinin değerlendirilmesi. KLİMİK Derg. 2016;29(2):65-70.
13. Fiore E, Van Tyne D, Gilmore MS. Pathogenicity of Enterococci.Microbiol Spectr. 2019;7(4):10.1128/microbiolspec.GPP3-0053-2018.
14. Bhardwaj SB. Pathogenic Bacteria. In: Enterococci: An ImportantNosocomial Pathogen, Kirmusaoglu S. Bhardwaj SB (eds).IntechOpen, 1st ed. London; 2019:1-17.
15. Sastry S, Clarke LG, Alrowais H, Querry AM, Shutt KA, DoiY. Clinical appraisal of fosfomycin in the era of antimicrobialresistance. Antimicrob Agents Chemother. 2015;59(12):7355-7361.
16. Mataj V, Guney M, Sig AK, et al. An Investigation into bacterialbloodstream infections and antibiotic resistance profiles in atertiary hospital for a ten-year period. Clin Lab. 2020;66(8):1467-1477.
17. Odemis I, Kose S, Ersan G, Celik D, Akbulut I. Evaluation ofantibiotic susceptibilities of Enterococcus strains isolated fromclinical samples of hospitalized patients. Turk Hij Den Biyol Derg.2018;75(4):345-352.
18. Conceição N, Oliveira CC, Silva PR, Avila BG, Oliveira AG.Trends in antimicrobial resistance among clinical isolates ofenterococci in a Brazilian tertiary hospital: a 4-year study. Rev SocBras Med Trop. 2011;44(2):177-181.
19. Boccella M, Santella B, Pagliano P, et al. Prevalence andantimicrobial resistance of Enterococcus Species: a retrospectivecohort study in Italy. Antibiotics (Basel). 2021;10(12):1552.
20. Agus N, Sirin MC, Yılmaz N, et al. The change of antibioticresistance over the years in enterococci isolated from clinicalspecimens. Ankem Derg. 2014;28:119-23.
21. Celik C, Taskın-Kafa AH, Hasbek M, Buyuktuna SA. Antimicrobialresistance in Enterococcus faecalis and Enterococcus faeciumbacteria isolated from bloodstream infections: a single-centerevaluation. Klimik Derg. 2021;34:37-41.
22. Sig AK, Kula Atik T, Çetin Duran A. Antibiotic resistance ofEnterococcus species:3-year data. J Health Sci Med. 2021;4(5):670-674.
23. Bilgin M, Gorgun S, Isler H, Basbulut E. Evaluation of thedistribution and antibiotic resistance profiles of Enterococcusspecies isolated from urine cultures. Turk Hij Den Biyol Derg.2021;78(3):265-272.
24. Simsek M. Species distribution and antibiotic suscebtibilitiesof Enterococci strains isolated from urine cultures. KTD.2019;20:177-182.
25. Etiz P, Kibar F, Ekenoglu Y, Yaman A. Evaluation of the AntibioticResistance Profiles of Enterococcus Species Isolated from UrineCultures. Türk Mikrobiyol Cem Derg. 2014;44(3):107-113.
26. Calderaro A, Maugeri A, Magazù S, Laganà G, Navarra M,Barreca D. Molecular basis of interactions between the antibioticnitrofurantoin and human serum albumin: a mechanism for therapid drug blood transportation. Int J Mol Sci. 2021;22(16):8740.
27. Yenisehirli G, Yenisehirli A, Bulut Y, Ozveren G. Antimicrobialresistance of enterococci isolated from urine cultures. KlimikDerg. 2016;29:112-116.
28. Ozseven AG, Cetin ES, Arıdogan BC, Ciftci E, Ozseven L.Antimicrobial susceptibility of enterococci isolated from variousclinical specimens. ANKEM Derg. 2011;25(4):256-262.
29. Iraz M, Ceylan A, Akkoyunlu Y. Antibiotic susceptibility ofEnterococcus strains isolated from various clinical samples.ANKEM Derg. 2012;26:176-180.
30. Ulusal Antimikrobiyal Direnc Surveyans Sistemi, 2016 YıllıkRaporu. 2016. Turkiye Halk Sagligi Kurumu, Saglik Bakanligi,Ankara, http://uamdss.thsk.gov.tr (Erişim: 22.06.2022).
31. Avcıoglu F, Altınoz Aytar A, Ozturk E, Sahin I, Calıskan E.Evaluation of vancomycin-resistant Enterococcus colonizationat Duzce Universty research and training hospital. Düzce Tıp FakDerg. 2016;18(1):8-11.
32. European Centre for Disease Prevention and Control. 2020.Antimicrobial resistance in the EU/EEA (EARS-Net)- AnnualEpidemiological Report 2019. (Erişim: 22.06.2022).
33. Ulusal Saglik Hizmeti Iliskili Enfeksiyonlar Surveyans Agi OzetRaporu. 2019. Halk Sagligi Genel Müdürlügü, Bulasici HastalıklarDairesi Baskanligi. (Erişim: 22.06.2022).
34. Ulusal Antimikrobiyal Direnc Surveyans Sistemi, 2019 YıllıkRaporu. 2019. Turkiye Halk Sagligi Kurumu, Saglik Bakanligi,Ankara, http://uamdss.thsk.gov.tr. (Erişim: 22.06.2022).
35. Genez H. Klinik orneklerden izole edilen enterokoklarınvirulans faktorlerinin yuksek duzey aminoglikozid direnciyleiliskilendirilmesi. Uzmanlık Tezi, Kocaeli Universitesi, TipFakültesi, Tıbbi Mikrobiyoloji Anabilim Dali, Kocaeli, 2021.
36. Turk Dagi H, Arslan U, Inci Tuncer E. Antibiotic resistance inenterococci isolated from blood cultures. Türk Mikrobiyol CemDerg. 2011;41(3):103-106.
37. Stefani S, Bongiorno D, Mongelli G, Campanile F. Linezolidresistance in staphylococci. Pharmaceuticals. 2010;3(7):1988-2006.
38. Dadashi M, Sharifian P, Bostanshirin N, et al. The globalprevalence of daptomycin, tigecycline, and linezolid-resistantEnterococcus faecalis and Enterococcus faecium strains fromhuman clinical samples: a systematic review and meta-analysis.Front Med (Lausanne). 2021;8:720647.
39. Kilbas I, Ciftci IH. Antimicrobial resistance of Enterococcusisolates in Turkey: a meta-analysis of current studies. J GlobAntimicrob Res. 2018;12:26-30.
40. Ozkan O, Ozbek B, Sınırtas M, Ozakın C. Tigecyclinesusceptibility among gram negative bacteria. Türk MikrobiyolCem Derg. 2011;41(1):42-45.
Article available in :
Volume 6, Issue 5, 2023
Page : 1052-1058
https://doi.org/10.32322/jhsm.1287070
Article Information
Received : 27 Nis 2023
Accepted : 07 Eyl 2023
Published : 28 Eyl 2023
Corresponding Author :

Hülya Duran: Medical Microbiology Laboratory, Tekirdağ Dr. I. Fehmi Cumalioğlu City Hospital, Tekirdağ, Turkey

[email protected]
Citation : Gedik T, Kiraz N, Duran H. The change of antibiotic resistance rates over the years in Enterococcus spp. isolated from clinical specimens. J Health Sci Med. 2023;6(5):1052-1058.

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