Vancomycin and high-level aminoglycoside resistance in Enterococcus species

Abstract

The aim of the study was to investigate vancomycin and high-level aminoglycoside resistance (HLAR) in Enterococcus species by phenotypic and genotypic methods. A hundred Enterococcus strains were included in the study. Antimicrobial susceptibilities of strains were investigated by automated system, betalactamase production was investigated by nitrocefin disks, vancomycin resistance and HLAR were investigated by gradient diffusion method (GDM) and disk diffusion method, respectively. For detection of vancomycin and high-level gentamicin resistance (HLGR) genes, polymerase chain reaction was used. Teicoplanin linezolid, vancomycin, ampicillin, penicillin are the most susceptible antibiotics and strains were detected not to produce beta lactamase. Vancomycin resistance was detected in ten isolates by automated system and in only five isolates by GDM. Five isolates carrying VanA gene were determined. The ratio of HLGR and high-level streptomycin resistance was found 40 and 63% respectively. aac (6’)-1eaph (2’’)-1a gene was detected in 58% of strains. E. faecium strains were found more resistant to the antibiotics than the other species. Beta lactamase was detected in none of strains. The automated system detected vancomycin resistance in more strains than GDM. Therefore it is concluded that strains, which were detected to be resistant to vancomycin, should be confirmed by GDM. The ratio of VanA gene in strains is consistent with other studies. The HLAR ratio was found in about half of strains. The ratio of aac(6’)-1e-aph(2’’)-1a gene, which is the most reported gene in our country and other countries and one of the HLGR genes investigated in our study, was detected 58%.

Keywords

• Enterococcus
• beta lactamase
• vancomycin
• high-level aminoglycoside
• resistance