Antimicrobial resistance of nosocomial Enterococcus spp. isolated from blood culture in patients with hematological malignancies

Abstract

Objective. To evaluate antimicrobial susceptibility of Enterococcus spp. isolated from blood culture in patients with hematological malignancies. Materials and Methods. Antimicrobial susceptibility of 427 Enterococcus spp. collected from 10 hospitals in 8 cities of Russia in 2002-2016 as part of the multicenter study was tested by the broth microdilution method [CLSI 2015]. Results. Among bloodstream pathogens there was a prevalence of E. faecium (78.2%), followed by E. faecalis (19.7%) and other Enterococcus spp. (2.1%). A total of 50 (15%) vancomycin-resistant E. faecium (Vancomycin-resistant Enterococcus – VRE) was detected, of them 33 (66%) were harboring vanA gene, 17 (34%) – vanB gene. In 2012 one linezolid resistant E. faecium (MIC = 16 µg/mL) was detected. Linezolid-resistant E. faecium contained the G2576T 23S rRNA mutation. All VRE faecium including the one linezolid-resistant isolate were susceptible to daptomycin. All E. faecium were susceptible to tigecycline, 78.7% – to chloramphenicol, 74.9% – to tetracycline. Proportion of E. faecium with high level resistance to gentamicin was 85%, to streptomycin – 60%, to both aminoglycosides – 45%. All E. faecalis were susceptible to linezolid, teicoplanin and tigecycline; 97.6% – to ampicillin. One isolate of E. faecalis (1.2%) with intermediate susceptibility to vancomycin (MIC = 16 µg/mL) harboring vanD gene and one isolate of E. gallinarum resistant to vancomycin, carrying vanC1 and vanB genes were detected. Conclusions. Isolates of E. faecalis had more favorable profile of antimicrobial susceptibility comparing to E. faecium. A total of 15% E. faecium were vancomycin resistant and one of them had resistance to linezolid. In this study one E. faecalis and one E. gallinarum isolates were non-susceptible to vancomycin.