Fecal Enterococci Levels in Selected Tributaries of the Pampanga River Basin, Philippines, and Their Relation to Land Use

This study aims to generate data which can be used as a potential starting point for the updating of the Philippine Water Quality Criteria and the determination of the true impact of land use to the fecal contamination of the Pampanga River Basin (PRB), the largest subwatershed of Manila Bay. Levels of fecal indicator bacteria (FIB) were determined in the selected tributaries of the PRB, representing three land use categories, namely, the forest/woodland (control), agricultural and residential lands. FIB were quantified in order to investigate the potential contribution of the selected areas in the fecal contamination of the PRB. The study was conducted in 2021 covering March, May, June, July, and September to represent the dry (March and May) and wet (June, July, and September) seasons. Counts of FIB, namely thermotolerant coliform, E. coli, and enterococci were qualitatively correlated with the results of the ocular survey and key informant interview based on known fecal contributors and their relevant rainfall data. FIB counts of water bodies in the selected agricultural and residential land use categories had Geometric Mean (GM) counts that are statistically greater than those of bodies of water near the representative forest/woodland (control), and exceeded the acceptable GM limits for all FIB, regardless of the season. Notably, the GM values recorded for the waters near the selected forest/woodland (control) passed the water quality criteria for all measured FIB parameters for both seasons. Furthermore, enterococci levels in the control site were statistically lower during the wet season. These initial findings suggest that agricultural and residential land use categories could be major contributors to the unacceptable water quality of tributaries of the Pampanga River Basin. The prevalence of thermotolerant coliforms and E. coli was noted regardless of rainfall and land use, indicating these FIB may not be adequate as water quality indicators. With their ability to survive and persist in fecally contaminated sediments in water bodies and in nutrient-poor environments, enterococci could be more definitive indicators of fecal contamination and microbiological quality of environmental waters.

Survival of Epidemic, Clinical, Faecal and Recreational Beach Enterococci Strains with Putative Virulence Genes in Marine and Fresh Waters

Culturable faecal coliform, epidemic, clinical, faecal and recreational beach enterococci strains possessing putative virulence genes were enumerated over the course of 5 weeks to comparatively assess their persistence in tropical marine and fresh waters. For the clinical and epidemic strains tested, it took 2.38 ± 0.45 days for a 1-log reduction (T90) in marine water. A higher T90 average of 2.51 ± 0.08 was observed for the commensal and environmental strains. Generally, lower T90 values of 2.14 ± 0.26 and 2.15 ± 0.16 days respectively were observed for hospital and community acquired enterococci strains in fresh water mesocosms subjected to tropical ambient temperature. Beach water enterococci and enterococci recovered from faeces of humans survived for up to 20 days and 23 days respectively in fresh and marine waters. The epidemic strain, MMH594, an esp-positive clinical bacteremia isolate that previously caused multiple infections in a hospital ward outbreak fares favourably well in tropical marine and fresh aquatic environments. For enterococci, the decay rate was approximately 13% higher in fresh water than was observed for marine water. On the contrary, for E. coli, the decay rate was approximately 17% lower in fresh water than was observed in marine water. Generally, the whole, the population trends of E. coli and enterococci in fresh and marine water mesocosms did not reveal any evidence of growth. Our findings suggest that potentially pathogenic bacteria can resume active growth after three weeks of being harboured by the reservoir-beach sand and still pose threat to public health.

Origin of de novo daptomycin non susceptible enterococci

The emergence of daptomycin non-susceptible enterococci(DNSE) poses both treatment and infection control challenges.Clinicians should be vigilant that DNSE may be isolated from patients with or without(de novo DNSE) prior use of daptomycin.Recent epidemiological data suggest the presence of a community reservoir for DNSE which may be associated with environmental,foodborne and agricultural exposures.The mechanisms of nonsusceptibility to daptomycin have not been well characterized and may not parallel those for Staphylococcus aureus.The identification of daptomycin resistance genes in anaerobes,in farm animals and in an ecosystem that has been isolated for million years,suggest that the environmental reservoir for de novo DNSE may be larger than previously thought.Herein,the limited available scientific evidence regarding the possible origin of de novo DNSE is discussed.The current existing evidence is not sufficient to draw firm conclusions on the origin of DNSE.Further studies to determine the mechanisms of de novo daptomycin nonsusceptibility among enterococci are needed.

Prevalence of Multidrug Resistant Enterococci in a Tertiary Care Hospital in India: A Growing Threat

Introduction: Enterococci are members of the healthy human intestinal flora, but are also leading causes of highly antibiotic-resistant infections. Serious enterococcal infections are often difficult to treat since the organisms have a tremendous capacity to acquire resistance to penicillin, high concentration of aminoglycoside & vancomycin. Careful review of in vitro susceptibility data is required to treat infections caused by MDR Enterococci. Therefore we conducted the study to find out prevalence of MDR Enterococci. Aims & Objectives: To study the prevalence of Vancomycin resistance, High Level Streptomycin Resistance (HLSR) & High Level Gentamicin Resistance (HLGR) in different enterococcal isolates. Materials & Methods: Total 180 enterococcal isolates were studied. Identification was done by conventional biochemical methods. Antibiotic susceptibility testing was done by Kirby-Bauer disc diffusion method on Mueller–Hinton agar and results were interpreted as per CLSI guidelines. HLSR & HLGR was determined by disc diffusion method using high level Gentamicin disc (120 μg) & Streptomycin (300 μg) discs. Minimum inhibitory concentration (MIC) determination for Vancomycin was done by vancomycin E test strips. Results: Total 180 entetococcal isolates were studied. E. faecalis was 60%, E. faecium was 32.2%, E. durans and E. raffinosus were 4.4% & 3.3% respectively. Enterococcus fecium showed resistance in high percentage as compared to E. faecalis. 15 isolates were found to be vancomycin resistant. Conclusion: Resistance to aminoglycoside is of great concern. Regular screening of enterococcal isolates for vancomycin resistance detection should be implemented. It is very important to implement infection control measures, screening of health care workers, surveillance cultures in intensive care units which can control spread of multidrug resistant enterococci.

Influence of enterococci on human sperm membrane in vitro

瞄准：在 vitro.Methods 在人的精子膜上学习 enterococci 的影响：呼喊的人的精子人工地感染 lysin 的β - 血或非 -- 在细菌的β - hemolyticenterococci：在 37 ℃的 50:1 的精子比率。精子膜正直被低亚硫酸钠为 1， 3 和 5 h 在孵化以后检验渗透的胀大(HOS ) 测试和电子 microscopy.Results：感染 lysin 的 enterococci 有的β - 血的精子降低 HOS 分数比较 withnon- β - 血 lysin 的紧张或 uninfected 控制(P 【 0.01 ) 。感染 lysin 的 enterococci 面对 phosphatidylcholine 增加了的β - 血的精子的 HOS 测试分数，禁止者 ofhemolysin。非 -- β - hemorytic 紧张没处于胀大的率显示出重要差别，与控制组相比(P 】 0.05 ) 。它被电子显微镜学看那β - 血 lysin 的 enterococcicaused 人的精子的重要破裂膜。结论：lysin 的 enterococci 引起了人的精子膜损害的β - 血，和力量被 enterococci 的血细胞溶解酵素调停。

Isolation and species identification of enterococci from clinical specimen with their antimicrobial susceptibility pattern in a tertiary care hospital,Bangladesh

Objective:To investigate the species prevalence of Enterococcus with their antimicrobial resistance pattern from patients of Dhaka Medical College Hospital.Methods:Samples were cultured and Enterococcus species were identified by conventional biochemical tests as well as PCR by using species specific primers for Enterococcus faecalis(E.faecalis)and Enterococcus faecium(E.faecium).For isolation of vancomycin resistant enterococci,minimum inhibitory concentration of vancomycin and PCR was done to detect vanA and vanB genes.Results:A total of 16 enterococci were isolated from 300 urine and 200 wound swab samples(15 from urine and 1 from wound swab)from July 2011 to June 2012.Enterococci were the third most common organism(8.47%)from urine after Escherichia coli(63.28%)and Enterobacter(11.87%).Out of 16 enterococci,10(62.5%)were E.faecalis,4(25%)were E.faecium and 2(12.5%)were other species.All the enterococci(100%)were sensitive to vancomycin and linezolid.Most of the strains were resistant to ciprofloxacin and azithromycin(87.5%),gentamycin(81.25%),ceftriaxone(75%),amoxiclav(31.25%)and imipenem(25%).E.faecium was more resistant than E.faecalis to azithromycin(100%),ciprofloxacin(100%),amoxiclav(75%)and imipenem(50%).No vancomycin resistant enterococci were identified and the range of minimum inhibitory concentration for vancomycin was 1-4μg/mL.None of the enterococci were positive for vanA and vanB genes.Conclusions:The presence of multidrug resistant enterococci should be considered as danger alarm for serious enterococcal infections and further study in large scale is needed.

氯己定擦浴预防ICU病人多重耐药菌感染效果的Meta分析

目的:系统评价氯己定全身擦浴对重症监护室(ICU)病人多重耐药菌感染的预防效果。方法:检索the Cochrane Library、PubMed、Web of Science、EMbase、中国知网、万方数据库、维普数据库、中国生物医学文献数据库中关于氯己定全身擦浴预防ICU病人多重耐药菌感染效果的中英文文献。由2名研究者根据纳入与排除标准独立筛选文献、质量评价及提取资料,采用Stata 16.0软件进行Meta分析。结果:最终纳入11项研究共23090例病人。Meta分析结果显示,与常规温水或肥皂水擦浴比较,氯己定能降低ICU病人多重耐药菌感染(OR=0.770,P<0.001)。其中氯己定全身擦浴能降低耐万古霉素肠球菌(VRE)(OR=0.664,P=0.004)及耐碳青霉烯类铜绿假单胞菌(CRPA)(OR=0.442,P=0.034)的感染发生风险,但不能降低耐甲氧西林金黄色葡萄球菌(MRSA)(OR=0.852,P=0.193)及耐碳青霉烯类鲍曼不动杆菌(CRAB)的感染发生风险(OR=0.888,P=0.537)。结论:现有证据显示,氯己定全身擦浴能降低ICU病人多重耐药菌感染,但仅对部分耐药菌有效。

Tracing enterococci persistence along a pork production chain from feed to food in China

The prevalence and transmission of vancomycin-resistant Enterococcus(VRE)in enterococci being as probiotics has been neglected in the scientific literature.The application of enterococci in feed,food and health products may cause VRE transmission through the food chain.This study evaluated phenotypic resistance of Enterococcus species to 20 antibiotics along a pork production chain from feed to food.It also assessed the genetic diversity of Enterococcus faecium isolates.A total of 510 samples(feed,n=70;swine manure,n=400;swine carcasses,n=20,and retail pork,n=20)were collected in Beijing,China.A total of 328 enterococci isolates with 275 E.faecium and 53 Enterococcus faecalis were identified using 16 S rRNA.Antimicrobial susceptibility to all enterococci isolates was conducted using the KeB method for 20 antibiotics from 9 categories.Multilocus sequence typing(MLST)was conducted on the E.faecium isolates to survey the dissemination of enterococci in the pig industry.The results showed that only 26 enterococci isolates were sensitive to the 20 antibiotics,while half of the isolates(164/328)had acquired multi-drug resistance.The resistant rate to furazolidone was 68.60%,followed by 42.99%to tetracycline.One vancomycin-resistant E.faecium isolates were isolated from feed origin and 2 from manure origin,with minimum inhibitory concentrations to vancomycin of 1,024,64,and 64 mg/mL,respectively.The MLST outcomes showed that the 275 E.faecium isolates belonged to 11 sequence types(ST)including ST40,ST60,ST94,ST160,ST178,ST296,ST361,ST695,ST726,ST812 and ST1014.The ST of the feedsourced VRE was ST1014,while the 2 manure-sourced VRE was ST69.ST1014 evolved from ST78,which was the dominant clonal complex in most cities of China,leading to the spreading of VRE.These findings revealed the potential safety hazards of commercial probiotic enterococci in China and showed that there is a risk of the VRE horizontally transferring from feed to food.

Investigation of the prevalence of patients co-colonized or infected with methiclllin-resistant Staphylococcus aureus and vancomycin- resistant enterococci in China： a hospital-based study

methicillin 抵抗的葡萄球菌 aureus (MRSA ) 和万古霉素抵抗的 enterococci (VRE ) 引起的背景医院的感染能导致增加的病态和死亡。在 2006，自从第一 VRE 医院的感染， VRE 医院的传播在 2003 在我们的医院里成为了现实。很少在病人与 VRE 和 MRSA 对共存的流行被知道。学习的主要目的是在2年的经期期间在一样的病人与 MRSA 和 VRE 在我们的医院和共存的流行里识别流行 MRSA 克隆的分子的特征， 2006-2007 .Methods 临床的特征，实验室测试结果，并且 129 个盒子的治疗学的结果从2006年1月孤立 MRSAcollected 到2007年12月的人，回顾地被分析。聚合酶链反应(PCR ) 被用来决定 mecA-femB 类型和 staphylococcal 盒子染色体 mec (SCCmec ) 打字。所有参加者被屏蔽为临床并且与 129 MRSA 孤立的 MRSA.Results 识别 VRE 紧张的共存的 microbiological 数据在学习被包括：71 (55%) 从特别护理联合起来， 35 (27.2%) 从外科的病房并且 23 (17.8%) 从医药病房。MRSA 的隔离的最经常的来源是唾沫(76.7%) 。从七个病人，我们孤立 MRSA 和 VRE (E。faecium ) 同时在他们的住院病人停留期间。127 (127/129， 98.4%) MRSA 孤立 harboured SCCmec 类型， 2 仅仅 MRSA 紧张包含了 SCCmec 类型。所有 129 MRSA 孤立对万古霉素， teicoplanin 和 linezolid 仍然保持敏感。更高的敏感率以氯霉素 99.2% 闻名(128/129 ) 。(26/129 ) 仅仅， 20.2% MRSA 孤立对 rifampin 敏感。所有与高最小的禁止的集中(MIC ) 孤立介绍抵抗到多重抗菌剂代理人，包括：酮(青霉素，新青霉素， cefoxitin，和 cefazolin )(ciprofloxacin， levofloxacin，和 moxifloxacin ) ，四圜素，抗生素的一种， gentamicin，和 quinolones .Conclusions 在从 2006 ～ 2007 的北京 Chaoyang 医院的占优势的 MRSA 克隆有类型 SCCmec 元素。所有 MRSA 孤立是到抗菌剂代理人的 multiresistant。在一样的病人的 MRSA 和 VRE 的共存的出现不是稀罕的。医生们应该对源于 MRSA 和 VRE 的感染给予更多的注意。好攻击的感染控制措施应该被采取阻止 multidrug 抵抗有机体的传播。

Biofilm Formation and Virulence Genes in Clinical Isolates of Enterococcus faecalis

Enterococcus faecalis is a Gram-positive bacterium commonly found in the gastrointestinal tract that can cause serious infections. Many enterococci have broad resistance to antibiotics including penicillin, cephalosporins, aminoglycosides and glycopeptides. There are several adaptation mechanisms that bacteria can undergo to become more resistant, among them is the formation of biofilm. Several genes have been linked to the increase in the capacity of biofilm formation by bacteria such as gelE, esp and asa1. The aim of this research was to evaluate the biofilm formation of 12 E. faecalis isolates collected in hospitals and a standard strain, as well as to evaluate the hydrophobicity of its membrane and the presence of virulence genes. All the isolates formed biofilm and the characteristics of their membrane were variable. In addition, the presence of at least one virulence gene was found in all the 12 isolates, and none of the genes in the standard strain, indicating the acquisition of these genes in the hospital environment. With this, we can conclude that there is a close relationship between biofilm formation, acquisition of antibiotic resistance and the presence of virulence genes.

万古霉素耐药肠球菌的同源性及耐药机制分析

目的探讨万古霉素耐药肠球菌(VRE)的同源性及主要耐药机制。方法收集我院临床分离的9株VRE,采用E-test法检测其对万古霉素等10种抗菌药物的最低抑菌浓度值,脉冲场凝胶电泳技术进行同源性分析,多重PCR技术扩增万古霉素耐药基因并测序。结果9株VRE均为屎肠球菌,共分为6个克隆,耐药表型和基因型均为vanA型。结论本院VRE为vanA基因型,VRE的增加与局部克隆传播、耐药基因的水平转移以及抗菌药物的选择压力有关。

肠球菌抗生素耐药基因检测

目的明确解放军第98医院临床分离的肠球菌中,抗生素耐药相关基因存在状况。方法采用聚合酶链反应(PCR)及序列分析的方法,分析15株粪肠球菌和9株屎肠球菌中,β-内酰胺类抗生素耐药相关基因(TEM)、氨基糖苷类抗生素耐药相关基因(氨基糖苷类修饰酶基因)[aac(6′)/aph(2″)、aph(3′)-Ⅲ、ant(2″)-Ⅰ、ant(4′,4″)、ant(6)-Ⅰ]、四环素耐药相关基因(tetM)、红霉素耐药相关基因(ermB、mefA)和万古霉素耐药相关基因(vanA、vanB)。结果24株肠球菌中TEM、aac(6′)/aph(2″)、aph(3′)-Ⅲ、ant(2″)-Ⅰ、ant(4′,4″)、ant(6)-Ⅰ、ermB、mefAt、etM、vanA和vanB 4基因的阳性分别为9株(37.5%)、17株(70.8%)、6株(25.0%)、0、0、10株(41.7%)、18株(75.0%)、0、10株(41.7%)、1株(4.2%)和1株(4.2%)。结论临床分离的肠球菌多重耐药严重;携带抗生素相关耐药基因是导致菌株对抗生素产生耐药的重要原因。

乌梅对308株临床菌株的抑菌效果

目的观察乌梅对临床菌株的抑菌效果。方法采用琼脂稀释法,对乌梅进行308株临床菌株的抑菌活性检测。结果乌梅对112株金黄色葡萄球菌、112株表皮葡萄球菌和28株肠球菌的MIC50分别为0.72、1.44、0.72mg/mL;其MIC90分别为1.44、1.44、0.72mg/mL。对肺炎克雷伯菌和大肠杆菌的MIC90分别为2.88、1.44mg/mL。结论乌梅对革兰阳性球菌和某些革兰阴性杆菌均有较好的抑菌活性。

重症监护病房肠球菌感染及体外药敏监测

目的 研究医院重症监护病房 (ICU)内肠球菌的感染现状并对其耐药性进行体外药敏监测。方法 用法国 生物梅里埃公司生产的VITEK32全自动细菌鉴定系统鉴定肠球菌 ,用K B法及E test试条法监测肠球菌耐药率。结果 ICU内 116株肠球菌中 ,以粪肠球菌分离率最高 ,为 75 .0 % ,屎肠球菌为 10 .3% ,居第 2位 ,116株肠球菌中检出耐氨苄西林肠球菌 (ARE) 16 .4 % ,氨基糖苷类高水平耐药肠球菌 (HLAR) 38.8% ,氨基糖苷类高水平耐药合并氨苄西林耐药株 6 .9% ,未检出耐万古霉素肠球菌 (VRE) ,但检出万古霉素中介肠球菌 (VIE) 3 4 %。结论 ICU内肠球菌耐药率呈上升趋势 ,须严密监测 ,预防耐药肠球菌的暴发流行。

猪源肠球菌的分离及生物特性的初报

本研究从猪粪便中分离了肠球菌两株 ,经菌种鉴定两株菌均为屎肠球菌。其生物特性的研究表明 :可耐受 1%的胆盐和 6 % Na Cl高盐 ,在 p H3.0条件下可存活 ,对绝大多数抗生素耐药。

肠球菌溶血素与其致病力的关系

目的 探讨肠球菌溶血素的毒力因子作用。方法 分别检测 3 9株临床标本分离的粪肠球菌以及 3 1株健康人群粪便分离的粪肠球菌的溶血素检出率 ;并检测了β溶血肠球菌、非 β溶血肠球菌对 9种抗生素的敏感性。 结果 临床菌株的溶血素检出率为 5 8.9% ,健康人群分离株的溶血素检出率为 19.3 % (P <0 .0 0 5 ) ;β溶血株对抗生素的耐药性明显高于非 β溶血株 (P <0 .0 1)。

临床分离肠球菌的耐药性监测与分析

目的 监测临床分离的 14 0株肠球菌对 16种常用抗菌药物的敏感性 ,为临床治疗肠球菌感染提供依据。方法 采用琼脂稀释法测定各抗菌药物对肠球菌的 MIC,计算 MIC50 、MIC90 和敏感率 ,采用快速硝噻吩纸片显色法对 14 0株肠球菌进行β-内酰胺酶测定。结果 万古霉素、替考拉宁对粪肠球菌和屎肠球菌的敏感性最高 ,均为10 0 % ,粪肠球菌对氨苄西林 /舒巴坦、亚胺培南和氨苄西林敏感率分别为 91.9%、90 .8%和 90 .8% ;屎肠球菌对氨苄西林 /舒巴坦、亚胺培南和氨苄西林分别为 92 .7%、82 .9%和 90 .2 % ;粪肠球菌、屎肠球菌以及其他肠球菌对头孢吡肟的敏感率最低分别为 14 .9%、9.8%和 0 ;青霉素和氨苄西林对粪肠球菌、屎肠球菌的药敏结果可推测对亚胺培南的敏感性。结论 万古霉素和替考拉宁仍是治疗肠球菌感染最有效的药物 。

微粒子病家蚕消化道内肠球菌的分布

从健康家蚕、感染微粒子病家蚕,以及感染细菌性肠道病家蚕的消化道分离了200株肠球菌,并进行了数值分类学鉴定,以探讨家蚕消化道中肠球菌的生态学分布和家蚕微孢子与肠球菌的相互关系.研究结果表明:与健康蚕相比,4龄或5龄起蚕添食微孢子的微粒子病家蚕消化道内,肠球菌的数量分别增加5.5×105倍和0.74×102倍;菌种数从6个分别下降为3个和4个;生化表型数从27个分别下降为13个和14个;在菌种分布上,Ent.avium的分布频率从健康蚕的56%分别下降至20%和38%,而Ent.faecium的分布频率从健康蚕的2%分别上升至40%和16%;分离菌株共有59个生化表型.

儿童肠球菌多重耐药与Ⅰ类整合子的检测

目的了解儿童临床分离肠球菌的耐药特征及其多重耐药与Ⅰ类整合子的相互关系。方法采用琼脂稀释法测定常用抗菌药物对152株肠球菌的最低抑菌浓度(MIC),用聚合酶链反应(PCR)检测肠球菌Ⅰ类整合子和Ⅰ类整合酶基因。结果屎肠球菌对氨苄西林、阿莫西林-克拉维酸、环丙沙星的耐药率分别为96.8%、95.2%和84.1%,粪肠球菌对上述3种抗菌药物的耐药率分别为23.6%、18.0%和49.4%,屎肠球菌的耐药率明显高于粪肠球菌(P<0.001);粪肠球菌中有2株对万古霉素的MIC为8μg/mL,粪肠球菌和屎肠球菌对替考拉宁均敏感。儿童多重耐药肠球菌发生率高达93.7%。屎肠球菌耐药模式以耐氨苄西林、红霉素、环丙沙星、利福平、四环素、高水平庆大霉素6种抗菌药物为主,占屎肠球菌的59%,粪肠球菌以耐四环素、红霉素、利福平、氯霉素、高水平庆大霉素5种抗菌药物为主,占粪肠球菌的26%。全部152株肠球菌未检测到Ⅰ类整合子,仅有5株检测到Ⅰ类整合酶基因。结论儿童肠球菌多重耐药十分严重,儿童肠球菌多重耐药与Ⅰ类整合子和Ⅰ类整合酶基因尚无明显关系。