AUTHOR=Kibwana Upendo O. , Manyahi Joel , Moyo Sabrina J. , Blomberg Bjørn , Roberts Adam P. , Langeland Nina , Mshana Stephen E. 

TITLE=Antimicrobial resistance profile of Enterococcus species and molecular characterization of Vancomycin resistant Enterococcus faecium from the fecal samples of newly diagnosed adult HIV patients in Dar es Salaam, Tanzania

JOURNAL=Frontiers in Tropical Diseases

VOLUME=5

YEAR=2024

URL=https://www.frontiersin.org/journals/tropical-diseases/articles/10.3389/fitd.2024.1307379

DOI=10.3389/fitd.2024.1307379

ISSN=2673-7515

ABSTRACT=<sec><title>Background</title><p>Enterococci are becoming clinically more important especially among immunocompromised patients. Of concern are vancomycin resistant enterococci (VRE) which have both intrinsic and acquired forms of resistance. This work aimed to determine the antimicrobial resistance patterns of <italic>Enterococcus</italic> spp. and characterize VRE isolate obtained from HIV-infected patient using whole genome sequencing (WGS).</p></sec><sec><title>Methods:</title><p>Antimicrobial susceptibility testing was done on 57 enterococci isolates by both the disk diffusion method and Epsilometer test (E-Test). WGS was performed on VRE isolate determined by E-test.</p></sec><sec><title>Results</title><p>Out of the 57 enterococci isolates; 58% (33/57) were <italic>E. faecalis</italic>, 39% (22/57) <italic>E. faecium</italic> and 4% (2/57) were <italic>E. gallinarum</italic>. The highest antimicrobial resistance was observed in <italic>E. faecalis</italic> isolates. The most prevalent antimicrobial resistance was observed towards quinupristin-dalfopristin (56%, 32/57), followed by ciprofloxacin (28%), tigecycline (18%), daptomycin (16%), chloramphenicol (14%), ampicillin and teicoplanin (2%). Multidrug resistance (MDR) was detected in 11% (6/57) of the isolates. Vancomycin resistance and high-level gentamycin resistance (HLGR) were observed in one <italic>E. faecium</italic> and one <italic>E. faecalis</italic> isolates respectively. The VRE was typed as ST80, carried <italic>van</italic>A and other resistance genes for aminoglycosides, tetracyclines, quinolones and ampicillin. Furthermore, the isolate had chromosomal mutations responsible for quinolone (<italic>gyrA (p.S83I)</italic> and <italic>parC (p.S80I)</italic> and ampicillin (<italic>pbp5)</italic> resistance.</p></sec><sec><title>Conclusions</title><p>The detection of VRE, HLGR and MDR in the study settings underscores the sustained surveillance of VRE in high-risk groups and institution of infection control measures for prompt identification and isolation of carriers to prevent the spread of VRE in the community and hospital settings.</p></sec>