Antimicrobial Resistance Genes of Vancomycin-Resistant Enterococci at Phramongkutklao Hospital
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Abstract
Enterococci infection is a serious medical problem due to resistance to many antimicrobial agents, including vancomycin. The most common of vancomycin resistant genes in Thailand were vanA and vanB, mainly vanA. Data on drug resistance genes of vancomycin-resistant enterococci in Thailand are not specific to those infected, lack of up-to-date information and studied only the vancomycin resistance gene. The purpose of this study was to determine the pattern of antimicrobial resistant genes in VRE at Phramongkutklao Hospital. Methods: Bacterial isolates obtained from patients with VRE infections between 1 January, 2014, and 1 April, 2018 at Phramongkutklao Hospital were reviewed. Clonal relationships were assessed by random amplified polymorphic DNA analysis and identified resistance genes of representative pathogens with whole genome sequencing analysis. Results: Forty-nine of the VRE strains were E. faecium. They were classified in seven groups according to amplified DNA bands. The predominant patterns were pattern A (55.1%) and pattern E was 26.53%. There was only one isolate in each group (D, F, G). Of the 7 representative VRE strains studied for their vancomycin resistance patterns, 4 strains were vanHAX gene. The VRE isolates tested were universally susceptible to linezolid and linezolid resistant gene was not detected. Conclusion: VRE were susceptible to linezolid. The majority of gene was vanA, found on plasmid and chromosome. Spread of vancomycin resistance genes to other persons can be prevented by standard and contact precaution.
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