Vancomycin-resistant enterococcus outbreak in a pediatric intensive care unit: report of successful interventions for control and prevention

The objective of this study is to retrospectively report the results of interventions for controlling a vancomycin-resistant enterococcus (VRE) outbreak in a tertiary-care pediatric intensive care unit (PICU) of a University Hospital. After identification of the outbreak, interventions were made at the following levels: patient care, microbiological surveillance, and medical and nursing staff training. Data were collected from computer-based databases and from the electronic prescription system. Vancomycin use progressively increased after March 2008, peaking in August 2009. Five cases of VRE infection were identified, with 3 deaths. After the interventions, we noted a significant reduction in vancomycin prescription and use (75% reduction), and the last case of VRE infection was identified 4 months later. The survivors remained colonized until hospital discharge. After interventions there was a transient increase in PICU length-of-stay and mortality. Since then, the use of vancomycin has remained relatively constant and strict, no other cases of VRE infection or colonization have been identified and length-of-stay and mortality returned to baseline. In conclusion, we showed that a bundle intervention aiming at a strict control of vancomycin use and full compliance with the Hospital Infection Control Practices Advisory Committee guidelines, along with contact precautions and hand-hygiene promotion, can be effective in reducing vancomycin use and the emergence and spread of vancomycin-resistant bacteria in a tertiary-care PICU.

Partial purification and characterization of a bacteriocin produced by Enterococcus faecium 130 isolated from mozzarella cheese

Lactic acid bacteria are important in foods as potential probiotics and also due to the ability to produce antimicrobial compounds that can contribute for biopreservation. In this work, the bacteriocin produced by the food isolate Enterococcus faecium 130 was partially purified and characterized. The compound was active against Gram-positive bacteria, including Listeria monocytogenes. It was produced after 4 days of storage at a broad temperature range (4 to 37 °C); it was stable at pH ranging from 2 to 10 with no loss of activity after heating at 100 °C for 15 minutes. Bacteriocin was partially purified by the adsorption-desorption technique, and the analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) showed a molecular mass of 3.5 to 6.5 kDa. These data encourage studies on application of this bacteriocin in food systems as an additional hurdle to microbial growth.

Epidemiología molecular de aislamientos clínicos de enterococcus faecalis de tres hospitales de tercer nivel de México.

Tesis (Maestría en Ciencias con Especialidad en Microbiología Médica) UANL, 2012.

Eficacia antimicrobiana de microdacyn 60, hipoclorito de sodio al 5.25% y MTAD contra enterococcus faecalis.

Tesis (Maestría en Ciencias Odontológicas con Especialidad en Endodoncia) UANL, 2012.

Efecto antimicrobiano de las nanopartículas de plata contra el microorganismo Enterococcus faecalis

Tesis (Maestría en Odontología Avanzada) UANL, 2014.

Évaluation de l'impact de l'utilisation de tylosine et de virginiamycine sur les profils de résistance aux antimicrobiens chez enterococcus SP. et Escherichia coli isolés de porcs

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

Untersuchungen zur Biofilmbildung bei dem klinischen Isolat Enterococcus faecalis 1.10

In der vorliegenden Arbeit wurde die Biofilmbildung bei einem klinischen Isolat von Enterococcus faecalis untersucht. Der Prozess der Biofilmbildung ist in mehrere Abschnitte unterteilt und beinhaltet zu Beginn eine Anhaftung von Zellen an Oberflächen. Dieser adhäsive Schritt wird unter anderem durch Pili vermittelt. Pili bei Grampositiven Mikroorganismen sind kovalent mit der Zellwand verknüpfte Proteinstrukturen, die eine Anheftung an biotische und abiotische Oberflächen sowie den Zell-Zell-Kontakt vermitteln. Bei den Analysen dieser Doktorarbeit lag ein besonderes Interesse bei eben diesen Pili, die für Enterococcus faecalis die Namen Ebp (endocarditis and biofilm associated pili) und Bee (biofilm enhancer in enterococci) tragen. Codiert werden sie durch die entsprechenden ebp-/bee-Loci, deren Aufbau unter den Grampositiven Mikroorganismen hochkonserviert ist. Die Loci bestehen aus Pilusuntereinheiten-codierenden Genen und colokalisierten Pilus-spezifischen Sortase Genen. Während in der Regel drei verschiedene Pilusuntereinheiten vorliegen, kann die Anzahl der Sortasen zwischen einer und zwei variieren. Bei den Experimenten wurde neben einer Komplementationsstudie zu einer Bee-Pilus Defekt-Mutante (1.10.16) das Hauptaugenmerk auf die Analyse des zweiten Pilus (Ebp) gelegt, um die Pilisituation bei Isolat 1.10 im Detail darzustellen Zusätzlich sollten weitere Oberflächenassoziierte Proteinstrukturen bei Isolat 1.10 detektiert werden, die gegebenenfalls an der Biofilmbildung beteiligt sind. Weitere Versuche zur Charakterisierung des Bee-Pilus wurden im Laufe dieser Arbeit durchgeführt, blieben jedoch bisher erfolglos. Die Biofilm-/Pilus-Defekt-Mutante 1.10.16 zeigte aufgrund einer Punktmutation (Pm) in der Pilus-spezifischen Sortase 1 des bee-Locus eine geschwächte Fähigkeit zur Anheftung an abiotische Oberflächen, sowie das Fehlen der Bee2 Untereinheit im Pilus. Nach Komplementation der Mutante (1.10.16K) mit dem Wildtyp-srt1 Gen, wurde die starke Biofilmbildungsfähigkeit zurück erlangt. Die Experimente zeigten, dass der Pilus-Defekt auf die Pm im srt1 Gen zurückzuführen war und der Bee-Pilus in Stamm 1.10.16K wieder korrekt gebildet wurde. Zu sehen war dies in Rasterelektronenmikroskopischen Aufnahmen und ebenfalls im massenspektrometrischen Nachweis aller 3 Pilusuntereinheiten im Bee-Pilus charakteristischen High-Molecular-Weight Komplex (~ 250 kDa). Durch Sequenzierungen konnte gezeigt werden, dass zwei Gene des ebp-Locus (ebpR und ebpC) bei Isolat 1.10 durch die Insertion von IS-Elementen IS1062 und IS6770 inaktiviert wurden. Der proteinbiochemische Nachweis über Pilusspezifische Antikörper gegen die Untereinheiten des Ebp-Pilus verlief negativ. Zusätzlich konnte gezeigt werden, dass die mRNA der beiden inaktivierten Gene nicht gebildet wurde. Dies führte folglich zum vollständigen Verlust des Ebp-Pilus bei Isolat 1.10. Zusammen mit den Ergebnissen der Komplementation konnte somit der große Einfluss mindestens eines intakten Pilus auf die Biofilmbildung gezeigt werden. Sind beide Pili durch Insertionen bzw. Mutationen inaktiviert, kommt es zu einer deutlichen Abnahme der Biofilmbildungsstärke. Dass trotzdem noch ein Biofilm gebildet wurde, zeigt den multifaktoriellen Zusammenhang bzw. Einfluss im Biofilmbildungsprozess. Über das gezielte Markieren von Oberflächenproteinen intakter Zellen mittels der Oberflächenbiotinylierung, konnten in der SDS-PAGE Unterschiede im Bandenmuster im Vergleich zur unbehandelten Probe erkannt werden. Die massenspektrometrische Identifikation dieser Proteine erfolgte bisher nicht, jedoch sind diese vorläufigen Ergebnisse vielversprechender Natur für die Identifikation und Aufklärung der Oberflächenproteinsituation bei Isolat 1.10.

Description of Enterococcus canis sp nov from dogs and reclassification of Enterococcus porcinus Teixeira et al. 2001 as a junior synonym of Enterococcus villorum Vancanneyt et al. 2001

Strains from anal swabs and chronic otitis externa in dogs were shown to be phylogenetically related to the Enterococcus faecium species group. They shared a number of phenotypic characteristics with these species, but they could be easily differentiated by biochemical reactions. In addition, the canine strains were unusual in their nearly complete failure to grow on sodium azide-containing enterococci-selective media and in their Voges-Proskauer reactions (usually negative). By using 16S rRNA sequencing and DNA-DNA hybridization of representative strains, as well as tDNA interspacer gene PCR and SDS-PAGE of whole-cell proteins, the group of canine strains was shown to constitute a novel enterococcal species. The name Enterococcus canis sp. nov. is proposed for this species, with LMG 12316(T) (= CCUG 46666(T)) as the type strain. Concurrently, the taxonomic situation and nomenclatural position of Enterococcus porcinus were investigated. As no phenotypic or genotypic differences were found between this species and Enterococcus villorum, the name E. porcinus is considered to be a junior synonym of E. villorum.

Estudo de bacteriocinas produzidas por espécies de Enterococcus

As enterocinas são compostos de natureza protéica que apresentam atividade antimicrobiana contra bactérias patogênicas e deteriorantes de alimentos. Por esta razão, nos últimos anos, o interesse por estas substâncias tem aumentado devido ao seu uso potencial como biopreservante de alimentos. Realizando uma triagem com 352 cepas de Enterococcus spp para detectar atividade antimicrobiana, foram encontradas 18 cepas (5%) produtoras de enterocinas, pertencentes às espécies E. faecalis, E. faecium e E. mundtii todas provenientes de amostras de fezes de humanos. Destas cepas foram produzidos sobrenadantes livres de células e realizados testes para caracterização das enterocinas produzidas. As enterocinas produzidas pelas 18 cepas apresentaram o mesmo espectro de atividade antimicrobiana, inibindo 4 espécies do gênero Listeria, Lactobacillus plantarum e Salmonella Enteritidis. Todas foram parcialmente estáveis ao aquecimento (121ºC por 10 minutos), a variações de pH de 2 a 10 e a estocagem por 60 dias a 4ºC e a -20ºC. A sensibilidade a proteases confirmou a natureza protéica destas substâncias antimicrobianas. Com cinco sobrenadantes livres de células foram realizadas curvas de produção de enterocinas e todas iniciaram a produção na fase logarítmica de crescimento, indicando cinética de metabólito primário. Com estes sobrenadantes foi determinado o peso molecular aproximado de 3 KDa, utilizando a técnica de SDS-PAGE. As cepas com atividade antimicrobiana no sobrenadante livre de células não apresentaram os genes para produção das enterocinas A e B, mas 14 cepas de E. faecium apresentaram o gene para enterocina A e 9 para enterocina B, sendo que apenas uma cepa apresentou ambos os genes. Nenhuma das 18 cepas produtoras de enterocinas apresentou atividade hemolítica e presença de adesinas, todas apresentaram cápsula. Os resultados obtidos neste trabalho indicam que estas enterocinas demonstram um potencial aplicabilidade em novos estudos relacionados aos biopreservantes.

Enterococcus SPP resistente à vancomicina : tipagem molecular, caracterização clínica e associação com mortalidade

Resumo não disponível

Efeitos do potencial probiótico Enterococcus faecium 32 e de sua associação com o extrato da alga marinha Caulerpa mexicana no tratamento de colite experimental murina

Ulcerative colitis comprising an inflammatory bowel disease, whose most severe consequence is the development of intestinal neoplasia. The drugs currently used to treat the disease trigger a variety of serious adverse effects and are not effective in many cases. Recent studies demonstrated the effectiveness of natural products for the treatment of inflammatory processes. Seaweed extracts and their purified products have shown protective effects in models of inflammation and the association of traditional therapies with probiotics has significantly improved the clinical symptoms of ulcerative colitis. Therefore, the aims of this study include evaluating the potential effects of the use of probiotic strain Enterococcus faecium 32 (Ef32), the methanolic extract of the green seaweed Caulerpa mexicana (M.E.) and their concomitant administration in a murine model of colitis induced by dextran sodium sulfate (DSS). Accordingly, C57BL /6 mice were pretreated orally with Ef32 (109 CFU/ml) for seven days. In the seven days following, the colitis was induced by administration of 3% DSS (w/v) diluted in the animals drinking water. During this period, animals were treated daily with Ef32 and the M.E. (2.0 mg/kg) every other day by intravenous route. The development of colitis was monitored by the disease activity index (DAI), which takes into account the loss of body weight, consistency and presence of blood in stools. After euthanasia, the colon was removed, its length measured and tissue samples were destined for histological analysis and culture for cytokine quantification. The levels of cytokines in the culture supernatant of the colon were measured by ELISA. The treatments with the probiotic Ef32 or the M.E. alone or the combination of these two substances provoked significant improvement as to weight loss and DAI, and prevented the shortening of the colon in response to DSS. The isolated treatments triggered a slight improvement in intestinal mucosal tissue damage. However, their combination was able to completely repair the injury triggered by DSS. The association was also able to reduce the levels of all the cytokines analyzed (IFN-γ, IL-4, IL-6, IL-12, IL-17A and TNF-α). On the other hand, the treatment with Ef32 did not interfere with the levels of TNF-α, whereas treatment with M.E. did not alter the levels of IL-6. Moreover, the treatment with Ef32 not interferes in TNF-α levels, whereas treatment with M.E. did not alter the levels of IL-6. Therefore, the potential probiotic Ef32 and M.E. and especially when these samples were associated proved promising alternatives in the treatment of ulcerative colitis as demonstrated in an experimental model because of its beneficial effects on morphological and clinical parameters, and by reducing the production of proinflammatory cytokines of Th1, Th2 and Th17

Antimicrobial resistance and species composition of Enterococcus spp. isolated from waters and sands of marine recreational beaches in Southeastern Brazil

Density, species composition and antimicrobial resistance in bacteria of the Enterococcus genus were evaluated in seawater and sands from 2 marine recreational beaches with different levels of pollution. The 2 beaches showed predominance of Enterococcus faecalis and Enterococcus faecium, in the water and the sand. Dry sand presented higher densities of Enterococcus sp. and higher frequency of resistant strains than wet sand and seawater. The beach with a higher degree of pollution presented higher percentages of resistant strains (66.7% and 61.5%, in sand and in water, respectively) and resistance to a larger number of antimicrobials compared with the less polluted beach, Ilha Porchat (35.7% and 31.25% of resistant strains in sand and water, respectively). in water samples, the highest frequencies of resistance were obtained against streptomycin (38.5%) and erythromycin (25%), whilst in sand, the highest frequencies were observed in relation to erythromycin and tetracycline (38.1% and 14.3%, respectively). These results show that water and sands from beaches with high indexes of faecal contamination of human origin may be potential sources of contamination by pathogens and contribute to the dissemination of bacterial resistance. (C) 2007 Elsevier Ltd. All rights reserved.

Intake of isoflavone-supplemented soy yogurt fermented with Enterococcus faecium lowers serum total cholesterol and non-HDL cholesterol of hypercholesterolemic rats

The aim of this study was to obtain an isoflavone-supplemented soy yogurt, fermented with Enterococcus faecium CRL 183 and Lactobacillus helveticus ssp jugurti, with suitable sensory properties and to assess the effects of the final product on blood lipids in hypercholesterolemic rats. Four isoflavone supplementation procedures were tested, in which the isoflavone was added at these stages: (1) before heat-treatment; (2) after heating and before fermentation; (3) after fermentation and (4) in the okara (by-product of soy milk) flour stirred into the fermented product when consumed. The products were subjected to a test of sensory acceptability. To assess their potential hypocholesterolemic properties in vivo, four groups of rats were used: control (C), hypercholesterolemic (H), hypercholesterolemic plus fermented product (HF) and hypercholesterolemic plus isoflavone-supplemented fermented product (HFI). Hypercholesterolemia was induced in rats of groups H, HF and HFI by feeding them on a commercial rat chow to which cholesterol and cholic acid had been added. Total, HDL and non-HDL cholesterol and triglycerides were measured in the blood of the rats. No significant sensorial differences were detected among the samples of soy yogurt supplemented with isoflavones at various processing stages. Rats fed a fermented soy product enriched with isoflavones (HFI group) had significantly (P < 0.05) less serum total cholesterol (15.5%) compared with rats fed a hypercholesterolemic diet (H group). Non-HDL cholesterol was less (P < 0.05) in rats fed a fermented soy product enriched or not with isoflavones (27.4 and 23.2%) compared to H group. The HDL-C and triglyceride concentrations did not differ significantly among the groups. It was possible to obtain an isoflavone-supplemented soy yogurt with satisfactory sensory characteristics. The resulting supplemented soy yogurt was capable of producing a lipid-lowering effect in hypercholesterolemic rats, relative to the animals that did not consume this product.

A soy-based product fermented by Enterococcus faecium and Lactobacillus helveticus inhibits the development of murine breast adenocarcinoma

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)