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CORRESPONDENCE
Year : 2015  |  Volume : 33  |  Issue : 3  |  Page : 455-456
 

Study of virulence factors in association with antimicrobial resistance amongst urinary isolates of enterococci


Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India

Date of Submission07-Feb-2014
Date of Acceptance26-May-2014
Date of Web Publication12-Jun-2015

Correspondence Address:
S Anupurba
Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0255-0857.158602

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How to cite this article:
Tiwari K, Banerjee T, Filgona J, Anupurba S. Study of virulence factors in association with antimicrobial resistance amongst urinary isolates of enterococci. Indian J Med Microbiol 2015;33:455-6

How to cite this URL:
Tiwari K, Banerjee T, Filgona J, Anupurba S. Study of virulence factors in association with antimicrobial resistance amongst urinary isolates of enterococci. Indian J Med Microbiol [serial online] 2015 [cited 2019 Nov 12];33:455-6. Available from: http://www.ijmm.org/text.asp?2015/33/3/455/158602


Dear Editor,

Enterococci are increasingly being revealed as reservoirs of mobile genetic elements carrying resistance and virulence genes to other pathogens. We studied the prevalence of various virulence factors phenotypically and genotypically in association with drug resistance among the enterococcal isolates implicated in urinary tract infection (UTI).

One hundred biochemically confirmed isolates of enterococci were tested for antimicrobial susceptibility by Kirby Bauer disc diffusion test and respective screen agars for vancomycin (VRE) and high level gentamicin (HLGRE) as per standard. [1] Haemolysin and gelatinase production, [2] hemagglutination and biofilm formation [3] and presence of asa1 (aggregation substance), gelE (gelatinase), cylA (cytolysin), esp (enterococcal surface protein) and hyl (hyaluronidase) by multiplex polymerase chain reaction (PCR) [4] was studied. Presence of virulence factors and drug resistance was compared by Kruskal Wallis test and Mann U Whitney test (statistical package of social sciences, SPSS, version 15, Chicago, US).

Of the total, 46 isolates were E. faecalis and 54 E. faecium, of which 70% (32 E. faecalis and 38 E. faecium) were HLGRE and 7% (1 E. faecalis and 6 E. faecium) were VRE. Haemolysin and gelatinase production, haemagglutination and biofilm formation was seen in 29%, 17%, 39% 34%, respectively. Virulence factors were more in E. faecalis (P > 0.05). asa1 and gelE were the most prevalent virulence genes [Figure 1]. None harboured all the virulent genes and 10 isolates did not show any virulence factors. Majority of the strong biofilm producers possessed either asa1 or gelE gene. On statistical analysis, decreasing expression and possession of virulence genes was seen with increasing drug resistance (P < 0.05). Acquisition of vancomycin resistance resulted in this decrease (P < 0.05).
Figure 1: Different virulent genes amongst the enterococcal isolates detected by multiplex PCR

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We found that just as increase in one aspect of survival fitness reduces the other, as seen in community and hospital acquired Methicillin-resistant Staphylococcus aureus (MRSA), [5] acquisition of plasmids for drug resistance might have led to loss of virulence due to fitness cost benefits relating to VRE.

 
 ~ References Top

1.
Clinical Laboratory and Standards Institute. Performance standard for antimicrobial susceptibility testing; Twenty first informational supplement 2011;M100:31.  Back to cited text no. 1
    
2.
Creti R, Imperi M, Bertuccini L, Fabretti F, Orefici G, Di Rosa R, et al. Survey for virulence determinants among Enterococcus faecalis isolated from different sources. J Med Microbiol 2004;53:13-20.  Back to cited text no. 2
    
3.
Kouidhi B, Zmantar T, Mahdouani K, Hentati H, Bakhrouf A. Antibiotic resistance and adhesion properties of oral Enterococci associated to dental caries. BMC Microbiol 2011;11:155.  Back to cited text no. 3
    
4.
Vankerckhoven V, Van Autgaerden T, Vael C, Lammens C, Chapelle S, Rossi R, et al. Development of a multiplex PCR for the detection of asa1, gelE, cylA, esp, and hyl genes in enterococci and survey for virulence determinants among European hospital isolates of Enterococcus faecium. J Clin Microbiol 2004;42:4473-9.  Back to cited text no. 4
    
5.
Cameron DR, Howden BP, Peleg AY. The Interface between antibiotic resistance and virulence in Staphylococcus aureus and its impact upon clinical outcomes. Clin Infect Dis 2011;53:576-82.  Back to cited text no. 5
    


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