Background Proactive infection control management is crucial in preventing the introduction of multiple drug resistant organisms in the healthcare setting. In Hong Kong, where vancomycin-resistant enterococci （VRE） ...Background Proactive infection control management is crucial in preventing the introduction of multiple drug resistant organisms in the healthcare setting. In Hong Kong, where vancomycin-resistant enterococci （VRE） endemicity is not yet established, contact tracing and screening, together with other infection control measures are essential in limiting intra- and inter-hospital transmission. The objective of this study was to illustrate the control measures used to eradicate a VRE outbreak in a hospital network in Hong Kong. Methods We described an outbreak of VRE in a healthcare region in Hong Kong, involving a University affiliated hospital and a convalescent hospital of 1600 and 550 beds respectively. Computer-assisted analysis was utilized to facilitate contact tracing, followed by VRE screening using chromogenic agar. Multi-locus sequence typing （MLST） was performed to assess the clonality of the VRE strains isolated. A case-control study was conducted to identify the risk factors for nosocomial acquisition of VRE. Results Between November 26 and December 17, 2011, 11 patients （1 exogenous case and 10 secondary cases） in two hospitals with VRE colonization were detected during our outbreak investigation and screening for 361 contact patients, resulting in a clinical attack rate of 2.8% （10/361）. There were 8 males and 3 females with a median age of 78 years （range, 40-87 years）. MLST confirmed sequence type ST414 in all isolates. Case-control analysis demonstrated that VRE positive cases had a significantly longer cumulative length of stay （P 〈0.001）, a higher proportion with chronic cerebral and cardiopulmonary conditions （P=0.001）, underlying malignancies （P 〈0.001）, and presence of urinary catheter （P 〈0.001）, wound or ulcer （P 〈0.001）, and a greater proportion of these patients were receiving β-lactam/ β-1actamase inhibitors （P=0.009）, carbapenem group （P 〈0.001）, fluoroquinolones （P=0.003）, or vancomycin （P=0.001） when compared with the controls. Conclusion Extensive contact tracing and screening with a ＂search-and-confine＂ strategy was a successful tool for outbreak control in our healthcare reqion.展开更多
Background The incidence of vancomycin-resistant enterococci （VRE） appeared to be increasing in China, but very few nosocomial outbreaks have been reported. Our hospital had experienced an outbreak of VRE since Marc...Background The incidence of vancomycin-resistant enterococci （VRE） appeared to be increasing in China, but very few nosocomial outbreaks have been reported. Our hospital had experienced an outbreak of VRE since March 2008 to March 2009. The objective of this study was to analyze the molecular features of the isolates and the control measures used to eradicate a VRE outbreak in a tertiary institution in China.Methods We characterized VRE isolates from 21 infected and 11 colonized inpatients from a single hospital by pulsed field gel electrophoresis （PFGE）, multilocus sequence typing （MLST）, the analysis of Tn 1546-like elements and virulence genes detection. Infection control measures, including more environmental disinfection, screening for VRE colonization,contact precautions, education and strict antibiotic restriction, were implemented to control the outbreak.Results During the outbreak, a total of 32 VRE strains were obtained. There were 21 strains found in Emergency Intensive Care Unit （EICU）, 9 isolates from Geriatric Ward, and two from other units. All the isolates harbored the vanA gene, however,four of them exhibited the VanB phenotype. Meanwhile, MLST analysis revealed that all isolates belonged to clonal complex （CC） 17. With the infection-control measures, the epidemic was constrained in two units （EICU and Geriatric Ward）. After March 2009, no further case infected with VRE was detected in the following one-year period.Conclusion The outbreak was controlled by continuous implementation of the infection control programme, and more rigorous infection control policy is needed.展开更多
Background:Vancomycin-resistant Enterococcus faecium ventriculitis is one of the most severe events in postneurosurgical intracranial infections.There are no guidelines recommending an appropriate treatment before.Cas...Background:Vancomycin-resistant Enterococcus faecium ventriculitis is one of the most severe events in postneurosurgical intracranial infections.There are no guidelines recommending an appropriate treatment before.Case presentation:This case presents a successful linezolid treatment for post-neurosurgical vancomycin-resistant Enterococcus faecium ventriculitis of a 24-year-old man in the department of neurosurgery,Beijing Tiantan Hospital.Conclusions:Linezolid should be considered as one of the important methods for the treatment of postneurosurgical intracranial infections caused by vancomycin-resistant Enterococcus.展开更多
Objective:To determine the inhibition mechanisms of secretome protein extracted from Paenibacillus polymyxa Kp10(Kp10)and Lactococcus lactis Gh1(Gh1)against methicillin-resistant Staphylococcus aureus(MRSA)and vancomy...Objective:To determine the inhibition mechanisms of secretome protein extracted from Paenibacillus polymyxa Kp10(Kp10)and Lactococcus lactis Gh1(Gh1)against methicillin-resistant Staphylococcus aureus(MRSA)and vancomycin-resistant Enterococcus(VRE).Methods:The sensitivity and viability of MRSA and VRE treated with secretome proteins of Kp10 and Gh1 were determined using minimal inhibitory concentration,minimum bactericidal concentration,and time-to-kill assays.The morphological changes were observed using scanning electron microscopy and transmission electron microscopy.To elucidate the antimicrobial mechanism of secretome protein of Kp10 and Gh1 against MRSA and VRE,2D gel proteomic analysis using liquid chromatography-mass spectrometry was run by comparing upregulated and downregulated proteins,and the proton motive force study including the efflux of ATP,pH gradient,and the membrane potential study were conducted.Results:MRSA and VRE were sensitive to Kp10 and Gh1 secretome protein extracts and displayed apparent morphological and internal composition changes.Several proteins associated with cellular component functions were either downregulated or upregulated in treated MRSA and VRE by changing the membrane potential gradient.Conclusions:Kp10 and Gh1 secretome proteins reduce the growth of VRE and MRSA by damaging the cell membrane.Cell division,cell wall biosynthesis,and protein synthesis are involved in the inhibition mechanism.展开更多
Background:This study aimed to investigate the effects of oral administration of Enterococcus faecium NCIMB10415(E.faecium)on intestinal development,immunological parameters and gut microbiota of neonatal piglets chal...Background:This study aimed to investigate the effects of oral administration of Enterococcus faecium NCIMB10415(E.faecium)on intestinal development,immunological parameters and gut microbiota of neonatal piglets challenged with enterotoxigenic Escherichia coli K88(ETEC).A total of 961-day-old sow-reared piglets were randomly assigned to 2 groups,with 48 piglets in each group.The piglets were from 16 litters(6 piglets each litter),and 3 piglets each litter were allocated to the E.faecium-supplemented(PRO)group,while the other 3 piglets were allocated to the control(CON)group.After colostrum intake,piglets in the PRO group were orally administrated with 3×10~9 CFU E.faecium per day for a period of one week.On day 8,one piglet per litter from each group was challenged(CON+ETEC,PRO+ETEC)or not(CON-ETEC,PRO-ETEC)with ETEC in a 2×2 factorial arrangement of treatments.On day 10(2 days after challenge),blood and tissue samples were obtained from piglets.Results:Before ETEC challenge,there were no significant differences for the average daily gain(ADG)and fecal score between the two groups of piglets.After ETEC challenge,the challenged piglets had greater fecal score compared to the non-challenged piglets,whereas E.faecium administration was able to decrease the fecal score.Piglets challenged with ETEC had shorter villous height,deeper crypt depth,and reduced number of goblet cells in the jejunum and decreased m RNA abundance of claudin-1 in the ileum,whereas increased the percentage of lymphocytes,concentrations of IL-1βin the plasma and TNF-αin the ileal mucosa,as well as increased the m RNA abundances of innate immunity-related genes in the ileum tissue.These deleterious effects caused by ETEC were partly alleviated by feeding E.faecium.In addition,piglets in PRO-ETEC group had decreased the percentage of CD8^+T cells of the peripheral blood when compared to those in CON-ETEC group.Moreover,E.faecium administration increased Verrucomicrobia at phylum level and decreased Bilophila at genus level.Conclusions:These results suggest that oral administration of E.faecium alleviated the intestinal injury and diarrhea severity of neonatal piglets challenged by ETEC,partly through improving the intestinal microbiota and immune response.This offers a potential strategy of dietary intervention against intestinal impairment by ETEC in neonatal piglets.展开更多
Background:Preventing Salmonella infection and colonization in young birds is key to improving poultry gut health and reducing Salmonella contamination of poultry products and decreasing salmonellosis for human consum...Background:Preventing Salmonella infection and colonization in young birds is key to improving poultry gut health and reducing Salmonella contamination of poultry products and decreasing salmonellosis for human consumption(poultry meat and eggs).Probiotics can improve poultry health.The present study was conducted to investigate the impact of a probiotics,Enterococcus faecium NCIMB 11181(E.faecium NCIMB 11181)on the intestinal mucosal immune responses,microbiome and barrier function in the presence or absence of Salmonella Typhimurium(S.Typh-imurium,ST)infection.Methods:Two hundred and forty 1-day-old Salmonella-free male broiler chickens(Arbor Acres AA+)were randomly allocated to four groups with 6 replicate cages of 10 birds each.The four experimental groups were follows:(1)nega-tive control(NC),(2)S.Typhimurium,challenged positive control(PC),(3)the E.faecium NCIMB 11181-treated group(EF),(4)the E.faecium NCIMB 11181-treated and S.Typhimurium-challenged group(PEF).Results:Results indicated that,although continuous feeding E.faecium NCIMB 11181 did not obviously alleviate growth depression caused by S.Typhimurium challenge(P>0.05),E.faecium NCIMB 11181 addition significantly blocked Salmonella intestinal colonization and translocation(P<0.05).Moreover,supplemental E.faecium NCIMB 11181 to the infected chickens remarkably attenuated gut morphological structure damage and intestinal cell apoptosis induced by S.Typhimurium infection,as evidenced by increasing gut villous height and reducing intes-tinal TUNEL-positive cell numbers(P<0.05).Also,E.faecium NCIMB 11181 administration notably promoting the production of anti-Salmonella antibodies in intestinal mucosa and serum of the infected birds(P<0.05).Addition-ally,16S rRNA sequencing analysis revealed that E.faecium NCIMB 11181 supplementation ameliorated S.Typhimu-rium infection-induced gut microbial dysbiosis by enriching Lachnospiracease and Alistipes levels,and suppressing Barnesiella abundance.Predicted function analysis indicated that the functional genes of cecal microbiome involved in C5-branched dibasic acid metabolism;valine,leucine and isoleucine biosynthesis;glycerolipid metabolism and lysine biosynthesis were enriched in the infected chickens given E.faecium NCIMB 11181.While alanine,asparate and glutamate metabolism;MAPK signal pathway-yeast;ubiquine and other terpenoid-quinore biosynthesis,protein processing in endoplasmic reticulum;as well as glutathione metabolism were suppressed by E.faecium NCIMB 11181 addition.Conclusion:Collectively,our data suggested that dietary E.faecium NCIBM 11181 supplementation could ameliorate S.Typhimurium infection-induced gut injury in broiler chickens.Our findings also suggest that E.faecium NCIMB 11181 may serve as an effective non-antibiotic feed additive for improving gut health and controlling Salmonella infection in broiler chickens.展开更多
Enterococci bacteria are important in environmental, food and clinical microbiology. Enterococcus faecium is a nosocomial pathogen that causes bacteremia, endocarditis and other infections. It is among the most preval...Enterococci bacteria are important in environmental, food and clinical microbiology. Enterococcus faecium is a nosocomial pathogen that causes bacteremia, endocarditis and other infections. It is among the most prevalent organisms encountered in hospital-associated infections accounting for approximately 12% of nosocomial infections in the USA （Linden and Miller, 1999）. However, certain strains of E. faecium are not only non-pathogenic but also have beneficial effects on human health with probiotic potential. For example, E. faecium T-110 is a consortium member in several probiotic products including BIO-THREE~ which is widely prescribed for human, animal and aqua-cultural use. This strain was originally developed by TOA Pharmaceuticals in Japan, and later used in the probiotic products of several other companies.展开更多
In the present study,we isolated the lactic acid bacterium strain SC-01 from Pacific white shrimp(Litopenaeus vannamei)intestine.Using conventional and molecular methods,we identified the bacterium as Enterococcus fae...In the present study,we isolated the lactic acid bacterium strain SC-01 from Pacific white shrimp(Litopenaeus vannamei)intestine.Using conventional and molecular methods,we identified the bacterium as Enterococcus faecium,and found it had the function of feeding attractant and could inhibit the development of Vibrio parahaemolyticus(zone of inhibition:14 mm).The attractant effect of its fermentation broth is significantly better than that of the chemical attractant trimethylamine oxide(TMAO)(P<0.05),and is equivalent to that of dimethyl-beta-propiothetin(DMPT)based on the feeding behavior of shrimp.High performance liquid chromatography(HPLC)analysis suggested that inosine-5’-monophosphate(IMP)may be a component of the attractant.A biosecurity evaluation revealed a negative result in hemolytic assays,and no shrimp mortality was resulted from SC-01 fermentation broth challenge.Feeding trials(60 days)indicated that the SC-01 fermentation broth(viable counts:5.7×109 cfu mL−1)could improve feed intake,weight gain rate(WGR)and specific growth rate(SGR),and decrease the count of Vibrio sp.in the intestine of shrimp.展开更多
BACKGROUND Bacillus subtilis(B.subtilis),Enterococcus faecium(E.faecium),and Enterococcus faecalis(E.faecalis)are probiotics that are widely used in the clinical treatment of irritable bowel syndrome(IBS).Whether the ...BACKGROUND Bacillus subtilis(B.subtilis),Enterococcus faecium(E.faecium),and Enterococcus faecalis(E.faecalis)are probiotics that are widely used in the clinical treatment of irritable bowel syndrome(IBS).Whether the supernatants of these three probiotics can improve gastrointestinal sensation and movement by regulating the serotonin transporter(SERT)expression needs to be clarified.AIM To investigate whether B.subtilis,E.faecium,and E.faecalis supernatants can upregulate SERT expression in vitro and in vivo.METHODS Caco-2 and HT-29 cells were stimulated with probiotic culture supernatants for 12 and 24 h,respectively.A male Sprague-Dawley rat model of post-infectious irritable bowel syndrome(PI-IBS)was established and the rats were treated with phosphate-buffered saline(group A)and three probiotics culture supernatants(groups B,C,and D)for 4 wk.The levels of SERT were detected by quantitative PCR and western blotting.RESULTS The levels of SERT at post-treatment 12 and 24 h were significantly elevated in Caco-2 cells treated with B.subtilis supernatant compared with those in the control group(aP<0.05).Those levels were markedly upregulated in Caco-2 cells stimulated with E.faecium and E.faecalis supernatants at 24 h(aP<0.05).In addition,SERT expression in groups B,C,and D was significantly higher than that in group A in the 2nd wk(aP<0.05).Increased SERT expression was only found in group D in the 3rd wk(aP<0.05).However,there was no significant difference in SERT expression between the groups in the last week(P>0.05).CONCLUSION The supernatants of B.subtilis,E.faecium,and E.faecalis can upregulate SERT expression in intestinal epithelial cells and the intestinal tissues in the rat model of PI-IBS.展开更多
Objective To identify a new peptide deformylase (PDF) gene (Genebank Accession AY238515) from Enterococcus faecium and to establish a new screening model targeted on PDF. Methods A new PDF gene was identified by BL...Objective To identify a new peptide deformylase (PDF) gene (Genebank Accession AY238515) from Enterococcus faecium and to establish a new screening model targeted on PDF. Methods A new PDF gene was identified by BLAST analysis and PCR and was subsequently over-expressed in the prokaryotic expression host E.coli Bl21(DE3). Over-expressed protein was purified for enzymatic assay by metal affinity chromatography and a new screening model was established for novel antibiotics. Result A new PDF gene of Enterococcus faecium was identified successfully. Ten positive samples were picked up from 8000 compound library and the microbial fermentation broth samples. Conclusion A new PDF of gene Enterococcus faecium was first identified and the model had a high efficacy. Positive samples screened may be antibacterial agents of broad spectrum.展开更多
Enterococcus faecalis and Enterococcus faecium rank among the leading causes of nosocomial bacteremia and urinary tract infections. They often persist on hospital surfaces due to their ability to withstand adverse env...Enterococcus faecalis and Enterococcus faecium rank among the leading causes of nosocomial bacteremia and urinary tract infections. They often persist on hospital surfaces due to their ability to withstand adverse environmental conditions (low or high temperatures, high pH, and high salinity). The global Enterococcus faecalis-Enterococcus faecium ratio is currently shifting towards Enterococcus faecium. Enterococci present variable levels of resistance to certain families of antibiotics. This is the case for aminoglycosides, beta-lactams and cephalosporins. In 2017, WHO ranked Enterococci among priority pathogens for research and development of new antibiotics. The objective of our study was to determine the antibiotic resistance profile of Enterococcus faecalis and Enterococcus faecium isolates from urine and pleural fluid in two hospitals in Cameroon. This cross-sectional and analytic study was carried out between June to August 2023 on hospitalized and day patients in which a cytobacteriological test of urine and pleural fluid was done. The samples were inoculated on CLED Agar for urine and on Chocolate + polyvitex and blood agar (prepared from Columbia agar) for pleural fluid samples and incubated at 37℃ for 18 to 24 hours. Identification of isolates was carried out using the API 20 STREP micro gallery (Biomerieux, France) and tested for antimicrobial susceptibility. The data on socio-demographical and potential risk factors were recorded using self-administered questionnaires and data from laboratory analyses of the specimen were collected in a data capture sheet. Potential risk factors associated with the presence of Enterococci, were evaluated using the logistic regression in univariate and multivariate analysis. P value < 0.05 was considered as significant. A total of 511 patients were recruited who were predominantly females. Enterococcus spp were isolated in 27.79% of our samples with Enterococcus faecalis mostly encountered. Enterococcus spp showed a high level of resistance to penicilline (99.3% to Ampicilline), macrolides (66.2% to Erythromycin) and cyclines (85.2% to Doxycycline). Hospitalisation, access to health facilities, contact with urine specimen and hand hygiene practices were risk factors related to infection with Enterococcus spp while hospitalisation, health facility and hand hygiene were related to glycopeptide resistant Enterococcus. Strict compliance with hygiene rules and appropriate antibiotic consumption could help in the fight against these infections.展开更多
In order to discover the risk factors for 30-day mortality in bloodstream infections（BSI） caused by Enterococcus spp.strains,we explored the clinical and therapeutic profile of patients with Enterococcus spp.BSI and...In order to discover the risk factors for 30-day mortality in bloodstream infections（BSI） caused by Enterococcus spp.strains,we explored the clinical and therapeutic profile of patients with Enterococcus spp.BSI and the characteristics of this condition.A total of 64 patients with BSI caused by Enterococcus spp.who were treated in our hospital between 2006 and 2015 were included in the study.The clinical features of patients,microbiology,and 30-day mortality were collected from the electronic medical records database and analyzed.The results showed that there were 38 patients infected by Enterococcus faecalis（E.faecalis）,24 by Enterococcus faecium（E.faecium）,1 by Enterococcus casseliflavus（E.casseliflavus）,and 1 by Enterococcus gallinarum（E.gallinarum）.A Charlson comorbidity score ≥5,corticosteroid treatment,placement of catheters or other prosthetic devices and history of antibiotic use were found more frequently in E.faecium BSI patients than in E.faecalis patients（P=0.017,P=0.027,P=0.008 and P=0.027,respectively）.Furthermore,the univariate and multivariate analysis showed that corticosteroid treatment（OR=17.385,P=0.008）,hospital acquisition（OR=16.328,P=0.038）,and vascular catheter infection（OR=14.788,P=0.025） were all independently associated with 30-day mortality.Our results indicate that E.faecalis and E.faecium are two different pathogens with unique microbiologic characteristics,which cause different clinical features in BSI,and the empiric antimicrobial treatments are paramount for patients with enterococcal BSI.展开更多
BACKGROUND Endophthalmitis caused by Enterococci is rare,and cases involving vancomycinresistant enterococci are even rarer.We report the first case of Enterococcus casseliflavus endophthalmitis associated with injury...BACKGROUND Endophthalmitis caused by Enterococci is rare,and cases involving vancomycinresistant enterococci are even rarer.We report the first case of Enterococcus casseliflavus endophthalmitis associated with injury caused by a pig.We also review reported cases of exogenous endophthalmitis caused by Enterococcus casseliflavus and discuss the clinical management and prognosis of this disease.CASE SUMMARY A 43-year-old man with no previous visual problems complained of endophthalmitis in his left eye following injury caused by a pig.Visual acuity was light perception and B-ultrasonography revealed vitreous opacities with retinal detachment.He was treated with intravitreal vancomycin and ceftazidime after refusing vitrectomy.However,the vitreous opacities and retinal detachment deteriorated and he underwent vitrectomy 5 d post-injury.Intraoperatively,advanced rhegmatogenous and tractional retinal detachment with proliferative vitreoretinopathy were observed.On postoperative day 5,vitreous cultures grew Gram-positive cocci identified as Enterococcus casseliflavus.A 2-wk course of intravenous ampicillin and dexamethasone was commenced.On postoperative day 14,visual acuity improved to hand movement.At 6 mo post-injury,visual acuity improved to 20/667,but optic atrophy was present.CONCLUSION Systemic administration of linezolid in the treatment of Enterococcus casseliflavus endophthalmitis can improve visual acuity.However,intravitreal amikacin should be considered despite concerns of toxicity when oral linezolid fails to prompt improvement.展开更多
Resistance against commonly used antibiotics is a serious clinical problem in recent medical practice. There exist several bacterial strains in which the possibilities of their inhibition are very limited due to multi...Resistance against commonly used antibiotics is a serious clinical problem in recent medical practice. There exist several bacterial strains in which the possibilities of their inhibition are very limited due to multidrug resistance. Antimicrobial photodynamic therapy (aPDT) represents an option how to effectively suppress the growth of resistant pathogens. In this work we have studied interactions of potent photosensitizer hypericin (Hyp) with hospital-related gram positive (Gram+) and gram negative (Gram-) bacterial strains and the effects of photodynamic activated Hyp on bacterial susceptibility and/or resistance of these strains to antibiotics. We demonstrated a significant influence of photoactivated Hyp on growth of Staphylococcus aureus and Enterococcus sp. We have also shown that it is extremely important to use the effective concentrations of Hyp for aPDT, which completely inhibit the growth of microorganisms. Otherwise, there appears an increase in resistance, probably due to the activation of efflux mechanisms, which are involved in the efflux of Hyp and antibiotics as well.展开更多
Background Vancomycin resistant enterococci(VRE)are now considered a global public health issue.In this study,we explored the relationship between vancomycin resistance incidence and various demographic and climatic f...Background Vancomycin resistant enterococci(VRE)are now considered a global public health issue.In this study,we explored the relationship between vancomycin resistance incidence and various demographic and climatic factors.Methods This retrospective study was performed between January 1st,2014 and December 31st,2021.Data covering the consumption of vancomycin,the prevalence of vancomycin resistance,and relevant demographics were collected.Spearman's rank correlation,beta regression,and spatial statistical analysis were performed using R version 4.2.2 and ArcGIS version 10.7.Results Spearman's rank correlation described the positive relation between vancomycin consumption and the prevalence of vancomycin resistant Enterococcus faecium(VRE_(fm)).Multiple regression analysis showed that vancomycin consumption,rural population,proportion of population aged≥65,annual temperature,and bed number in medical institutions per thousand people were significantly correlated with VRE_(fm)prevalence(r=56.22,p<0.001;r=0.0002,p<0.001;r=0.06,p<0.001;r=−0.07,p<0.001;and r=−0.37,p<0.001,respectively).Conclusions Vancomycin utilization was the predominant factor contributing to VRE_(fm)resistance;the effects of rural populations and the proportion of the population aged≥65 were significant but relatively minimal.Annual temperature and the number of beds in medical institutions per thousand people were protective factors against VRE_(fm).展开更多
文摘Background Proactive infection control management is crucial in preventing the introduction of multiple drug resistant organisms in the healthcare setting. In Hong Kong, where vancomycin-resistant enterococci （VRE） endemicity is not yet established, contact tracing and screening, together with other infection control measures are essential in limiting intra- and inter-hospital transmission. The objective of this study was to illustrate the control measures used to eradicate a VRE outbreak in a hospital network in Hong Kong. Methods We described an outbreak of VRE in a healthcare region in Hong Kong, involving a University affiliated hospital and a convalescent hospital of 1600 and 550 beds respectively. Computer-assisted analysis was utilized to facilitate contact tracing, followed by VRE screening using chromogenic agar. Multi-locus sequence typing （MLST） was performed to assess the clonality of the VRE strains isolated. A case-control study was conducted to identify the risk factors for nosocomial acquisition of VRE. Results Between November 26 and December 17, 2011, 11 patients （1 exogenous case and 10 secondary cases） in two hospitals with VRE colonization were detected during our outbreak investigation and screening for 361 contact patients, resulting in a clinical attack rate of 2.8% （10/361）. There were 8 males and 3 females with a median age of 78 years （range, 40-87 years）. MLST confirmed sequence type ST414 in all isolates. Case-control analysis demonstrated that VRE positive cases had a significantly longer cumulative length of stay （P 〈0.001）, a higher proportion with chronic cerebral and cardiopulmonary conditions （P=0.001）, underlying malignancies （P 〈0.001）, and presence of urinary catheter （P 〈0.001）, wound or ulcer （P 〈0.001）, and a greater proportion of these patients were receiving β-lactam/ β-1actamase inhibitors （P=0.009）, carbapenem group （P 〈0.001）, fluoroquinolones （P=0.003）, or vancomycin （P=0.001） when compared with the controls. Conclusion Extensive contact tracing and screening with a ＂search-and-confine＂ strategy was a successful tool for outbreak control in our healthcare reqion.
文摘Background The incidence of vancomycin-resistant enterococci （VRE） appeared to be increasing in China, but very few nosocomial outbreaks have been reported. Our hospital had experienced an outbreak of VRE since March 2008 to March 2009. The objective of this study was to analyze the molecular features of the isolates and the control measures used to eradicate a VRE outbreak in a tertiary institution in China.Methods We characterized VRE isolates from 21 infected and 11 colonized inpatients from a single hospital by pulsed field gel electrophoresis （PFGE）, multilocus sequence typing （MLST）, the analysis of Tn 1546-like elements and virulence genes detection. Infection control measures, including more environmental disinfection, screening for VRE colonization,contact precautions, education and strict antibiotic restriction, were implemented to control the outbreak.Results During the outbreak, a total of 32 VRE strains were obtained. There were 21 strains found in Emergency Intensive Care Unit （EICU）, 9 isolates from Geriatric Ward, and two from other units. All the isolates harbored the vanA gene, however,four of them exhibited the VanB phenotype. Meanwhile, MLST analysis revealed that all isolates belonged to clonal complex （CC） 17. With the infection-control measures, the epidemic was constrained in two units （EICU and Geriatric Ward）. After March 2009, no further case infected with VRE was detected in the following one-year period.Conclusion The outbreak was controlled by continuous implementation of the infection control programme, and more rigorous infection control policy is needed.
文摘Background:Vancomycin-resistant Enterococcus faecium ventriculitis is one of the most severe events in postneurosurgical intracranial infections.There are no guidelines recommending an appropriate treatment before.Case presentation:This case presents a successful linezolid treatment for post-neurosurgical vancomycin-resistant Enterococcus faecium ventriculitis of a 24-year-old man in the department of neurosurgery,Beijing Tiantan Hospital.Conclusions:Linezolid should be considered as one of the important methods for the treatment of postneurosurgical intracranial infections caused by vancomycin-resistant Enterococcus.
基金supported by the funds of Ministry of Higher Education,Malaysia and Universiti Putra Malaysia through Fundamental Research Grant Scheme (FRGS/1/2017/SKK11/UPM/01/1) and Putra Grant (GP/2017/9571800)
文摘Objective:To determine the inhibition mechanisms of secretome protein extracted from Paenibacillus polymyxa Kp10(Kp10)and Lactococcus lactis Gh1(Gh1)against methicillin-resistant Staphylococcus aureus(MRSA)and vancomycin-resistant Enterococcus(VRE).Methods:The sensitivity and viability of MRSA and VRE treated with secretome proteins of Kp10 and Gh1 were determined using minimal inhibitory concentration,minimum bactericidal concentration,and time-to-kill assays.The morphological changes were observed using scanning electron microscopy and transmission electron microscopy.To elucidate the antimicrobial mechanism of secretome protein of Kp10 and Gh1 against MRSA and VRE,2D gel proteomic analysis using liquid chromatography-mass spectrometry was run by comparing upregulated and downregulated proteins,and the proton motive force study including the efflux of ATP,pH gradient,and the membrane potential study were conducted.Results:MRSA and VRE were sensitive to Kp10 and Gh1 secretome protein extracts and displayed apparent morphological and internal composition changes.Several proteins associated with cellular component functions were either downregulated or upregulated in treated MRSA and VRE by changing the membrane potential gradient.Conclusions:Kp10 and Gh1 secretome proteins reduce the growth of VRE and MRSA by damaging the cell membrane.Cell division,cell wall biosynthesis,and protein synthesis are involved in the inhibition mechanism.
基金supported by the Projects of The National Key Research and Development Program of China(grant number 2016YFD0501204)Sichuan provincial project on S&T application and demonstration(grant number2016CC0070)the project on commercialization of research findings under funding of government of Sichuan province(grant number16ZHSF0385).
文摘Background:This study aimed to investigate the effects of oral administration of Enterococcus faecium NCIMB10415(E.faecium)on intestinal development,immunological parameters and gut microbiota of neonatal piglets challenged with enterotoxigenic Escherichia coli K88(ETEC).A total of 961-day-old sow-reared piglets were randomly assigned to 2 groups,with 48 piglets in each group.The piglets were from 16 litters(6 piglets each litter),and 3 piglets each litter were allocated to the E.faecium-supplemented(PRO)group,while the other 3 piglets were allocated to the control(CON)group.After colostrum intake,piglets in the PRO group were orally administrated with 3×10~9 CFU E.faecium per day for a period of one week.On day 8,one piglet per litter from each group was challenged(CON+ETEC,PRO+ETEC)or not(CON-ETEC,PRO-ETEC)with ETEC in a 2×2 factorial arrangement of treatments.On day 10(2 days after challenge),blood and tissue samples were obtained from piglets.Results:Before ETEC challenge,there were no significant differences for the average daily gain(ADG)and fecal score between the two groups of piglets.After ETEC challenge,the challenged piglets had greater fecal score compared to the non-challenged piglets,whereas E.faecium administration was able to decrease the fecal score.Piglets challenged with ETEC had shorter villous height,deeper crypt depth,and reduced number of goblet cells in the jejunum and decreased m RNA abundance of claudin-1 in the ileum,whereas increased the percentage of lymphocytes,concentrations of IL-1βin the plasma and TNF-αin the ileal mucosa,as well as increased the m RNA abundances of innate immunity-related genes in the ileum tissue.These deleterious effects caused by ETEC were partly alleviated by feeding E.faecium.In addition,piglets in PRO-ETEC group had decreased the percentage of CD8^+T cells of the peripheral blood when compared to those in CON-ETEC group.Moreover,E.faecium administration increased Verrucomicrobia at phylum level and decreased Bilophila at genus level.Conclusions:These results suggest that oral administration of E.faecium alleviated the intestinal injury and diarrhea severity of neonatal piglets challenged by ETEC,partly through improving the intestinal microbiota and immune response.This offers a potential strategy of dietary intervention against intestinal impairment by ETEC in neonatal piglets.
基金supported by the grant from Talent Plan of Zaozhuang City(2022),Shandong,China.The company had no role in conducting the research,generating the data,interpreting the results,or writing the manuscript。
文摘Background:Preventing Salmonella infection and colonization in young birds is key to improving poultry gut health and reducing Salmonella contamination of poultry products and decreasing salmonellosis for human consumption(poultry meat and eggs).Probiotics can improve poultry health.The present study was conducted to investigate the impact of a probiotics,Enterococcus faecium NCIMB 11181(E.faecium NCIMB 11181)on the intestinal mucosal immune responses,microbiome and barrier function in the presence or absence of Salmonella Typhimurium(S.Typh-imurium,ST)infection.Methods:Two hundred and forty 1-day-old Salmonella-free male broiler chickens(Arbor Acres AA+)were randomly allocated to four groups with 6 replicate cages of 10 birds each.The four experimental groups were follows:(1)nega-tive control(NC),(2)S.Typhimurium,challenged positive control(PC),(3)the E.faecium NCIMB 11181-treated group(EF),(4)the E.faecium NCIMB 11181-treated and S.Typhimurium-challenged group(PEF).Results:Results indicated that,although continuous feeding E.faecium NCIMB 11181 did not obviously alleviate growth depression caused by S.Typhimurium challenge(P>0.05),E.faecium NCIMB 11181 addition significantly blocked Salmonella intestinal colonization and translocation(P<0.05).Moreover,supplemental E.faecium NCIMB 11181 to the infected chickens remarkably attenuated gut morphological structure damage and intestinal cell apoptosis induced by S.Typhimurium infection,as evidenced by increasing gut villous height and reducing intes-tinal TUNEL-positive cell numbers(P<0.05).Also,E.faecium NCIMB 11181 administration notably promoting the production of anti-Salmonella antibodies in intestinal mucosa and serum of the infected birds(P<0.05).Addition-ally,16S rRNA sequencing analysis revealed that E.faecium NCIMB 11181 supplementation ameliorated S.Typhimu-rium infection-induced gut microbial dysbiosis by enriching Lachnospiracease and Alistipes levels,and suppressing Barnesiella abundance.Predicted function analysis indicated that the functional genes of cecal microbiome involved in C5-branched dibasic acid metabolism;valine,leucine and isoleucine biosynthesis;glycerolipid metabolism and lysine biosynthesis were enriched in the infected chickens given E.faecium NCIMB 11181.While alanine,asparate and glutamate metabolism;MAPK signal pathway-yeast;ubiquine and other terpenoid-quinore biosynthesis,protein processing in endoplasmic reticulum;as well as glutathione metabolism were suppressed by E.faecium NCIMB 11181 addition.Conclusion:Collectively,our data suggested that dietary E.faecium NCIBM 11181 supplementation could ameliorate S.Typhimurium infection-induced gut injury in broiler chickens.Our findings also suggest that E.faecium NCIMB 11181 may serve as an effective non-antibiotic feed additive for improving gut health and controlling Salmonella infection in broiler chickens.
文摘Enterococci bacteria are important in environmental, food and clinical microbiology. Enterococcus faecium is a nosocomial pathogen that causes bacteremia, endocarditis and other infections. It is among the most prevalent organisms encountered in hospital-associated infections accounting for approximately 12% of nosocomial infections in the USA （Linden and Miller, 1999）. However, certain strains of E. faecium are not only non-pathogenic but also have beneficial effects on human health with probiotic potential. For example, E. faecium T-110 is a consortium member in several probiotic products including BIO-THREE~ which is widely prescribed for human, animal and aqua-cultural use. This strain was originally developed by TOA Pharmaceuticals in Japan, and later used in the probiotic products of several other companies.
基金the Special Fund for Qingdao Marine Biomedical Science and Technology Innovation Center,China(No.2017-CXZX01-3-13).
文摘In the present study,we isolated the lactic acid bacterium strain SC-01 from Pacific white shrimp(Litopenaeus vannamei)intestine.Using conventional and molecular methods,we identified the bacterium as Enterococcus faecium,and found it had the function of feeding attractant and could inhibit the development of Vibrio parahaemolyticus(zone of inhibition:14 mm).The attractant effect of its fermentation broth is significantly better than that of the chemical attractant trimethylamine oxide(TMAO)(P<0.05),and is equivalent to that of dimethyl-beta-propiothetin(DMPT)based on the feeding behavior of shrimp.High performance liquid chromatography(HPLC)analysis suggested that inosine-5’-monophosphate(IMP)may be a component of the attractant.A biosecurity evaluation revealed a negative result in hemolytic assays,and no shrimp mortality was resulted from SC-01 fermentation broth challenge.Feeding trials(60 days)indicated that the SC-01 fermentation broth(viable counts:5.7×109 cfu mL−1)could improve feed intake,weight gain rate(WGR)and specific growth rate(SGR),and decrease the count of Vibrio sp.in the intestine of shrimp.
基金Supported by the National Natural Science Foundation of China,No.81570489and the Youth Project of National Natural Science Foundation of China,No.81900487.
文摘BACKGROUND Bacillus subtilis(B.subtilis),Enterococcus faecium(E.faecium),and Enterococcus faecalis(E.faecalis)are probiotics that are widely used in the clinical treatment of irritable bowel syndrome(IBS).Whether the supernatants of these three probiotics can improve gastrointestinal sensation and movement by regulating the serotonin transporter(SERT)expression needs to be clarified.AIM To investigate whether B.subtilis,E.faecium,and E.faecalis supernatants can upregulate SERT expression in vitro and in vivo.METHODS Caco-2 and HT-29 cells were stimulated with probiotic culture supernatants for 12 and 24 h,respectively.A male Sprague-Dawley rat model of post-infectious irritable bowel syndrome(PI-IBS)was established and the rats were treated with phosphate-buffered saline(group A)and three probiotics culture supernatants(groups B,C,and D)for 4 wk.The levels of SERT were detected by quantitative PCR and western blotting.RESULTS The levels of SERT at post-treatment 12 and 24 h were significantly elevated in Caco-2 cells treated with B.subtilis supernatant compared with those in the control group(aP<0.05).Those levels were markedly upregulated in Caco-2 cells stimulated with E.faecium and E.faecalis supernatants at 24 h(aP<0.05).In addition,SERT expression in groups B,C,and D was significantly higher than that in group A in the 2nd wk(aP<0.05).Increased SERT expression was only found in group D in the 3rd wk(aP<0.05).However,there was no significant difference in SERT expression between the groups in the last week(P>0.05).CONCLUSION The supernatants of B.subtilis,E.faecium,and E.faecalis can upregulate SERT expression in intestinal epithelial cells and the intestinal tissues in the rat model of PI-IBS.
基金This work was supported by National Natural Science Foundation of China (grant 30270042) and Technology Platform of New Drugs Screen from Ministry of Science and Technology of China (2002AA22343D).
文摘Objective To identify a new peptide deformylase (PDF) gene (Genebank Accession AY238515) from Enterococcus faecium and to establish a new screening model targeted on PDF. Methods A new PDF gene was identified by BLAST analysis and PCR and was subsequently over-expressed in the prokaryotic expression host E.coli Bl21(DE3). Over-expressed protein was purified for enzymatic assay by metal affinity chromatography and a new screening model was established for novel antibiotics. Result A new PDF gene of Enterococcus faecium was identified successfully. Ten positive samples were picked up from 8000 compound library and the microbial fermentation broth samples. Conclusion A new PDF of gene Enterococcus faecium was first identified and the model had a high efficacy. Positive samples screened may be antibacterial agents of broad spectrum.
文摘Enterococcus faecalis and Enterococcus faecium rank among the leading causes of nosocomial bacteremia and urinary tract infections. They often persist on hospital surfaces due to their ability to withstand adverse environmental conditions (low or high temperatures, high pH, and high salinity). The global Enterococcus faecalis-Enterococcus faecium ratio is currently shifting towards Enterococcus faecium. Enterococci present variable levels of resistance to certain families of antibiotics. This is the case for aminoglycosides, beta-lactams and cephalosporins. In 2017, WHO ranked Enterococci among priority pathogens for research and development of new antibiotics. The objective of our study was to determine the antibiotic resistance profile of Enterococcus faecalis and Enterococcus faecium isolates from urine and pleural fluid in two hospitals in Cameroon. This cross-sectional and analytic study was carried out between June to August 2023 on hospitalized and day patients in which a cytobacteriological test of urine and pleural fluid was done. The samples were inoculated on CLED Agar for urine and on Chocolate + polyvitex and blood agar (prepared from Columbia agar) for pleural fluid samples and incubated at 37℃ for 18 to 24 hours. Identification of isolates was carried out using the API 20 STREP micro gallery (Biomerieux, France) and tested for antimicrobial susceptibility. The data on socio-demographical and potential risk factors were recorded using self-administered questionnaires and data from laboratory analyses of the specimen were collected in a data capture sheet. Potential risk factors associated with the presence of Enterococci, were evaluated using the logistic regression in univariate and multivariate analysis. P value < 0.05 was considered as significant. A total of 511 patients were recruited who were predominantly females. Enterococcus spp were isolated in 27.79% of our samples with Enterococcus faecalis mostly encountered. Enterococcus spp showed a high level of resistance to penicilline (99.3% to Ampicilline), macrolides (66.2% to Erythromycin) and cyclines (85.2% to Doxycycline). Hospitalisation, access to health facilities, contact with urine specimen and hand hygiene practices were risk factors related to infection with Enterococcus spp while hospitalisation, health facility and hand hygiene were related to glycopeptide resistant Enterococcus. Strict compliance with hygiene rules and appropriate antibiotic consumption could help in the fight against these infections.
基金funded by Shenzhen Scientific Research Program(No.JCYJ20150402152130173)Scientific Research Project of Shenzhen Health and Family Planning System(No.201601058)Scientific Research Program of Shenzhen Nanshan District of China(No.2015019,2015022,2016010)
文摘In order to discover the risk factors for 30-day mortality in bloodstream infections（BSI） caused by Enterococcus spp.strains,we explored the clinical and therapeutic profile of patients with Enterococcus spp.BSI and the characteristics of this condition.A total of 64 patients with BSI caused by Enterococcus spp.who were treated in our hospital between 2006 and 2015 were included in the study.The clinical features of patients,microbiology,and 30-day mortality were collected from the electronic medical records database and analyzed.The results showed that there were 38 patients infected by Enterococcus faecalis（E.faecalis）,24 by Enterococcus faecium（E.faecium）,1 by Enterococcus casseliflavus（E.casseliflavus）,and 1 by Enterococcus gallinarum（E.gallinarum）.A Charlson comorbidity score ≥5,corticosteroid treatment,placement of catheters or other prosthetic devices and history of antibiotic use were found more frequently in E.faecium BSI patients than in E.faecalis patients（P=0.017,P=0.027,P=0.008 and P=0.027,respectively）.Furthermore,the univariate and multivariate analysis showed that corticosteroid treatment（OR=17.385,P=0.008）,hospital acquisition（OR=16.328,P=0.038）,and vascular catheter infection（OR=14.788,P=0.025） were all independently associated with 30-day mortality.Our results indicate that E.faecalis and E.faecium are two different pathogens with unique microbiologic characteristics,which cause different clinical features in BSI,and the empiric antimicrobial treatments are paramount for patients with enterococcal BSI.
基金Supported by National Natural Science Foundation of China,No.81660169
文摘BACKGROUND Endophthalmitis caused by Enterococci is rare,and cases involving vancomycinresistant enterococci are even rarer.We report the first case of Enterococcus casseliflavus endophthalmitis associated with injury caused by a pig.We also review reported cases of exogenous endophthalmitis caused by Enterococcus casseliflavus and discuss the clinical management and prognosis of this disease.CASE SUMMARY A 43-year-old man with no previous visual problems complained of endophthalmitis in his left eye following injury caused by a pig.Visual acuity was light perception and B-ultrasonography revealed vitreous opacities with retinal detachment.He was treated with intravitreal vancomycin and ceftazidime after refusing vitrectomy.However,the vitreous opacities and retinal detachment deteriorated and he underwent vitrectomy 5 d post-injury.Intraoperatively,advanced rhegmatogenous and tractional retinal detachment with proliferative vitreoretinopathy were observed.On postoperative day 5,vitreous cultures grew Gram-positive cocci identified as Enterococcus casseliflavus.A 2-wk course of intravenous ampicillin and dexamethasone was commenced.On postoperative day 14,visual acuity improved to hand movement.At 6 mo post-injury,visual acuity improved to 20/667,but optic atrophy was present.CONCLUSION Systemic administration of linezolid in the treatment of Enterococcus casseliflavus endophthalmitis can improve visual acuity.However,intravitreal amikacin should be considered despite concerns of toxicity when oral linezolid fails to prompt improvement.
文摘Resistance against commonly used antibiotics is a serious clinical problem in recent medical practice. There exist several bacterial strains in which the possibilities of their inhibition are very limited due to multidrug resistance. Antimicrobial photodynamic therapy (aPDT) represents an option how to effectively suppress the growth of resistant pathogens. In this work we have studied interactions of potent photosensitizer hypericin (Hyp) with hospital-related gram positive (Gram+) and gram negative (Gram-) bacterial strains and the effects of photodynamic activated Hyp on bacterial susceptibility and/or resistance of these strains to antibiotics. We demonstrated a significant influence of photoactivated Hyp on growth of Staphylococcus aureus and Enterococcus sp. We have also shown that it is extremely important to use the effective concentrations of Hyp for aPDT, which completely inhibit the growth of microorganisms. Otherwise, there appears an increase in resistance, probably due to the activation of efflux mechanisms, which are involved in the efflux of Hyp and antibiotics as well.
基金supported by grants from the National Natural Science Foundation of China(No.72304275 and No.82273696).
文摘Background Vancomycin resistant enterococci(VRE)are now considered a global public health issue.In this study,we explored the relationship between vancomycin resistance incidence and various demographic and climatic factors.Methods This retrospective study was performed between January 1st,2014 and December 31st,2021.Data covering the consumption of vancomycin,the prevalence of vancomycin resistance,and relevant demographics were collected.Spearman's rank correlation,beta regression,and spatial statistical analysis were performed using R version 4.2.2 and ArcGIS version 10.7.Results Spearman's rank correlation described the positive relation between vancomycin consumption and the prevalence of vancomycin resistant Enterococcus faecium(VRE_(fm)).Multiple regression analysis showed that vancomycin consumption,rural population,proportion of population aged≥65,annual temperature,and bed number in medical institutions per thousand people were significantly correlated with VRE_(fm)prevalence(r=56.22,p<0.001;r=0.0002,p<0.001;r=0.06,p<0.001;r=−0.07,p<0.001;and r=−0.37,p<0.001,respectively).Conclusions Vancomycin utilization was the predominant factor contributing to VRE_(fm)resistance;the effects of rural populations and the proportion of the population aged≥65 were significant but relatively minimal.Annual temperature and the number of beds in medical institutions per thousand people were protective factors against VRE_(fm).
