MyMedR

Fulltext Screening and detection of heterogenous vancomycin intermediate Staphylococcus aureus in Hospital Kuala Lumpur Malaysia, using the glycopeptide resistance detection Etest and population analysis profiling

Ramli SR, Neoh HM, Aziz MN, Hussin S

Infect Dis Rep, 2012 Jan 2;4(1):e20.

PMID: 24470927 DOI: 10.4081/idr.2012.e20

In a 3-month study done in Hospital Kuala Lumpur (HKL), 7 out of 320 methicillin resistant Staphylococcus aureus isolates were confirmed as heterogeneous vancomycin intermediate S. aureus (hVISA) using the glycopeptide resistance detection e-test and population analysis, giving a prevalence rate of 2.19%. This is the first report of hVISA in Malaysia.

Matched MeSH terms: Vancomycin Resistance

Fulltext Vancomycin-resistant Enterococcus faecium of multi locus sequence type 18 in Malaysia

Poh LW, Rukman AW, Cheah YK, Norital Z, Nazri AM, Mariana NS

Med J Malaysia, 2012 Dec;67(6):639-40.

PMID: 23770967 MyJurnal

Vancomycin-resistant Enterococcus faecium (VREF) in human infections mostly belong to the high-risk, epidemic, clonal complex-17 (CC17) group. Treatment limitation and high conjugation frequency makes it dominant in hospitals worldwide. We investigated positive cultures by Pulse-field gel electrophoresis (PFGE), multi locus sequence typing (MLST). DNA of two strains (A2 and C) appeared to be clonally related by PFGE. Three strains were of ST 18 type (A1, B and C) and strain A2 is of a new ST 596. This ST 18 type strain found in our study is crucial and is believed to be the first in Malaysia.

Matched MeSH terms: Vancomycin Resistance*

Occurrence of vancomycin-resistant enterococci in ducks in Malaysia

Shah-Majid M, Azlina AM, Ana Maria AR, Zaharah B, Norhaliza AH

Vet Rec, 2004 Nov 20;155(21):680-1.

PMID: 15581146

Matched MeSH terms: Vancomycin Resistance*

Occurrence of vancomycin-resistant enterococci in chickens in Malaysia

Shah-Majid M, Maria AR, Shahidayani S, Salwani AM, Khairani S

Vet Rec, 2007 May 19;160(20):702-3.

PMID: 17513839

Matched MeSH terms: Vancomycin Resistance*

Fulltext The presence of heterogeneous vancomycin-lntermediate Staphylococcus aureus (heteroVISA) in a major Malaysian hospital

Norazah A, Law NL, Abd Ghani MK, Salbiah N

Med J Malaysia, 2012 Jun;67(3):269-73.

PMID: 23082415

This study was conducted to detect the presence of heterogenous vancomycin-intermediate Staphylococcus aureus (heteroVISA) among MRSA isolates in a major hospital. Forty-three MRSA isolates with vancomycin MIC 2 microg/ml collected in 2009 was screened for heteroVISA using Etest Glycopeptide Resistance Detection (GRD) and confirmed by population analysis profile-area under curve method. The genetic relatedness of heteroVISA strains with other MRSA was examined by pulsed-field gel electrophoresis (PFGE) method. Two isolates were shown to be heteroVISA and derived from the same clone. This showed that heteroVISA strains were already present among our local strains since 2009 and were genetically related to other susceptible strains.

Matched MeSH terms: Vancomycin Resistance*

Community-acquired vancomycin-resistant Enterococcus faecium: a case report from Malaysia

Raja NS, Karunakaran R, Ngeow YF, Awang R

J Med Microbiol, 2005 Sep;54(Pt 9):901-903.

PMID: 16091445 DOI: 10.1099/jmm.0.46169-0

Vancomycin-resistant enterococci (VRE) are formidable organisms renowned for their ability to cause infections with limited treatment options and their potential for transferring resistance genes to other Gram-positive bacteria. Usually associated with nosocomial infections, VRE are rarely reported as a cause of community-acquired infection. Presented here is a case of community-acquired infection due to vancomycin-resistant Enterococcus faecium. The patient had been applying herbal leaves topically to his cheek to treat a buccal space abscess, resulting in a burn of the overlying skin. From pus aspirated via the skin a pure culture of E. faecium was grown that was resistant to vancomycin with a MIC of >256 microg ml-1 by the E test and resistant to teicoplanin by disc diffusion, consistent with the VanA phenotype. The organism was suspected of contaminating the leaf and infecting the patient via the burnt skin. This case highlights the need for further studies on the community prevalence of VRE among humans and animals to define unrecognized silent reservoirs for VRE, which may pose a threat to public health.

Matched MeSH terms: Vancomycin Resistance*

Fulltext Characterization of vancomycin-resistant Enterococcus isolates from broilers in Selangor, Malaysia

Getachew YM, Hassan L, Zakaria Z, Saleha AA, Kamaruddin MI, Che Zalina MZ

Trop Biomed, 2009 Dec;26(3):280-8.

PMID: 20237442 MyJurnal

Vancomycin-resistant Enterococcus (VRE) is an emerging nosocomial pathogen in humans. The use of antibiotics in human therapy and in the production of food animals has been incriminated in the emergence of this organism. The present study describes the distribution of VRE species, the vancomycin-resistant genes detected, the vancomycin resistance pattern observed, and the genetic diversity of the isolates found in live broiler chickens in Malaysia. Overall 140 VRE were isolated with species comprising Enterococcus faecalis (48%), Enterococcus faecium (25.7%), Enterococcus gallinarum (12.1%), Enterococcus casseliflavus (1.4%) and other Enterococcus species (12.8%). Vancomycin resistance gene vanA and intrinsic genes vanC1 and vanC2/3 were detected in the study population. VanA was detected in 15 (63.9%) of E. faecium, 23 (22.4%) of E. faecalis and in 3 (17.6%) E. gallinarum isolates. E-test was conducted on randomly selected 41 of the isolates and the minimum inhibition concentration (MIC) of vancomycin for five (11.9%) of tested isolates is more than 256 μg/ml. Genotypic analysis using random amplified polymorphic DNA (RAPD) showed genetic diversity within the Enterococcus species.

Matched MeSH terms: Vancomycin Resistance/genetics*

Fulltext Characterization and risk factors of vancomycin-resistant Enterococci (VRE) among animal-affiliated workers in Malaysia

Getachew Y, Hassan L, Zakaria Z, Zaid CZ, Yardi A, Shukor RA, et al.

J Appl Microbiol, 2012 Nov;113(5):1184-95.

PMID: 22906187 DOI: 10.1111/j.1365-2672.2012.05406.x

This study determined the risk factors and characteristics of vancomycin-resistant Enterococci (VRE) among individuals working with animals in Malaysia.

Matched MeSH terms: Vancomycin Resistance*

Low prevalence of vancomycin- and bifunctional aminoglycoside-resistant enterococci isolated from poultry farms in Malaysia

Chan YY, Abd Nasir MH, Yahaya MA, Salleh NM, Md Dan AD, Musa AM, et al.

Int J Food Microbiol, 2008 Feb 29;122(1-2):221-6.

PMID: 18187222 DOI: 10.1016/j.ijfoodmicro.2007.11.063

A total of 225 samples from poultry farms and the surrounding environment were screened for vancomycin-resistant enterococci (VRE) and bifunctional aminoglycoside-resistant enterococci using conventional microbiological tests and a nanoplex polymerase chain reaction (PCR) assay. Three (1.3%) of the samples were found to contain vancomycin-resistant isolates (MIC>256 microg/mL) that had a vanA genotype. The three vanA positive VRE isolates were identified as different species. Only one isolate (Enterococcus faecium F 4/13_54) was sensitive to teicoplanin (MIC<0. 12-0.35 microg/mL); the other two VRE (E. faecalis A 21_35 and E. gallinarum F 5/10_1) were resistant to teicoplanin (MIC 3.6-->16 microg/mL). The vanC genotype was observed in nine (4%) of the samples collected. High-level gentamicin-resistant (HLGR) enterococci (with MIC ranging between 100 and 500 microg/mL) were detected in 44 samples. However, only 40 of these were found to possess the aac(6')-aph(2'') gene. The overall prevalence of VRE among the samples from the poultry farms and environment was 5.3%, but the prevalence of the clinically significant vanA VRE was 1.3%, and the prevalence of bifunctional aminoglycoside-resistant enterococci was slightly higher, at 19.5%.

Matched MeSH terms: Vancomycin Resistance*

Microbial analysis of Malaysian tempeh, and characterization of two bacteriocins produced by isolates of Enterococcus faecium

Moreno MR, Leisner JJ, Tee LK, Ley C, Radu S, Rusul G, et al.

J Appl Microbiol, 2002;92(1):147-57.

PMID: 11849339

Isolation of bacteriocinogenic lactic acid bacteria (LAB) from the Malaysian mould-fermented product tempeh and characterization of the produced bacteriocin(s).

Matched MeSH terms: Vancomycin Resistance/genetics

Hemolytic and nonhemolytic vancomycin-resistant Enterococcus faecalis isolated from beef imported to Malaysia

Fifadara N, Radu S, Hassan Z, Beuchat LR, Rusul G

J Food Prot, 2003 Oct;66(10):1845-50.

PMID: 14572222

Twenty-two strains of vancomycin-resistant Enterococcus faecalis were isolated from 9 (6%) of 150 samples of frozen beef and beef products imported to Malaysia. The isolates were obtained from eight samples of beef and one sample of minced beef patty. No E. faecalis was isolated from frankfurters. Twelve of the 22 isolates (54.5%) were beta-hemolytic, and all isolates harbored the vanA gene. All vancomycin-resistant isolates were also resistant to streptomycin, erythromycin, kanamycin, bacitracin, ceftazimide, gentamycin, tetracycline, nalidixic acid, and teicoplanin; 95.4% were resistant to trimethoprimsulfamethoxazole; 68.8% were resistant to chloramphenicol; and 41% were resistant to ampicillin and penicillin. Small plasmids ranging in size from 1.5 to 5.8 kb were detected in 8 (36.4%) of 22 strains. The 22 isolates were classified into 20 random amplified polymorphic DNA types. Isolates were divided into two groups, each containing subclusters, that may reflect their clonal lineages. It is concluded that several clones of vancomycin-resistant E. faecalis are represented in the isolates obtained from beef imported to Malaysia.

Matched MeSH terms: Vancomycin Resistance*

Fulltext Genetic variability of vancomycin-resistant Enterococcus faecium and Enterococcus faecalis isolates from humans, chickens, and pigs in Malaysia

Getachew Y, Hassan L, Zakaria Z, Abdul Aziz S

Appl Environ Microbiol, 2013 Aug;79(15):4528-33.

PMID: 23666337 DOI: 10.1128/AEM.00650-13

Vancomycin-resistant enterococci (VRE) have been reported to be present in humans, chickens, and pigs in Malaysia. In the present study, representative samples of VRE isolated from these populations were examined for similarities and differences by using the multilocus sequence typing (MLST) method. Housekeeping genes of Enterococcus faecium (n = 14) and Enterococcus faecalis (n = 11) isolates were sequenced and analyzed using the MLST databases eBURST and goeBURST. We found five sequence types (STs) of E. faecium and six STs of E. faecalis existing in Malaysia. Enterococcus faecium isolates belonging to ST203, ST17, ST55, ST79, and ST29 were identified, and E. faecium ST203 was the most common among humans. The MLST profiles of E. faecium from humans in this study were similar to the globally reported nosocomial-related strain lineage belonging to clonal complex 17 (CC17). Isolates from chickens and pigs have few similarities to those from humans, except for one isolate from a chicken, which was identified as ST203. E. faecalis isolates were more diverse and were identified as ST4, ST6, ST87, ST108, ST274, and ST244, which were grouped as specific to the three hosts. E. faecalis, belonging to the high-risk CC2 and CC87, were detected among isolates from humans. In conclusion, even though one isolate from a chicken was found clonal to that of humans, the MLST analysis of E. faecium and E. faecalis supports the findings of others who suggest VRE to be predominantly host specific and that clinically important strains are found mainly among humans. The infrequent detection of a human VRE clone in a chicken may in fact suggest a reverse transmission of VRE from humans to animals.

Matched MeSH terms: Vancomycin Resistance*

Susceptibility pattern of Staphylococcus aureus isolated in Malaysian hospitals

Rohani MY, Raudzah A, Lau MG, Zaidatul AA, Salbiah MN, Keah KC, et al.

Int J Antimicrob Agents, 2000 Jan;13(3):209-13.

PMID: 10724026

Isolates of 390 Staphylococcus aureus were tested against 13 different antibiotics by a disc diffusion method as recommended by the National Committee for Clinical Laboratory Standards (NCCLS). Strains were isolated from blood (5.7%), cerebrospinal fluid (0.5%), respiratory tract (11.8%), pus and wound (73.3%), urine (1.8%), genital specimens (1.0%) and other specimens (4.3%). Only 4.6% of the isolates were fully susceptible to all the drugs tested. Resistance to penicillin was 94.1%, methicillin, 39.7%, chloramphenicol, 8.5%, ciprofloxacin, 29.2%, clindamycin, 2.1%, erythromycin, 45.9% gentamicin, 40.5%; rifampicin, 3.3% tetracycline, 47.2%, co-trimoxazole, 38.5%, mupirocin, 2.8%, fusidic acid, 3.6%. None of the isolates was resistant to vancomycin. The susceptibility of methicillin-resistant strains to erythromycin, gentamicin, tetracycline and ciprofloxacin was low, while clindamycin, fusidic acid, mupirocin, and rifampicin remained active.

Matched MeSH terms: Vancomycin Resistance

Fulltext High Level Aminoglycoside Resistance And Distribution Of The Resistance Genes In Enterococcus faecalis And Enterococcus faecium From Teaching Hospital In Malaysia

Moussa AA, Md Nordin AF, Hamat RA, Jasni AS

Infect Drug Resist, 2019;12:3269-3274.

PMID: 31695445 DOI: 10.2147/IDR.S219544

Background: Enterococcus faecium and Enterococcus faecalis are among the predominant species causing hospital-acquired infections. Currently, enterococcal infections are treated using combination therapy of an aminoglycoside with cell-wall active agents, which led to high level aminoglycoside resistance (HLAR) and vancomycin resistance (VRE) among enterococci. The aim of this study was to determine the prevalence of HLAR and the distribution of the resistance genes among clinical E. faecalis and E. faecium isolates in Malaysia.

Materials and methods: Seventy-five enterococci isolates recovered from different clinical sources were re-identified by subculturing on selective medium, Gram staining, biochemical profiling (API 20 Strep), and 16s rRNA sequencing. Antimicrobial susceptibility testing (AST) was performed using Kirby-Bauer disc diffusion, E-test, and broth microdilution methods. PCR amplification was used to detect the presence of aminoglycoside modifying enzyme (AME) genes [aac(6')-Ie-aph(2")-Ia, aph(2")-Ib, aph(2")-Ic, aph(2")-Id, aph(3')-IIIa]. Descriptive data analysis was used to analyze the antibiotic susceptibility profiles and the distribution of HLAR genes.

Results: The majority of the isolates recovered from the clinical samples are E. faecalis (66.7%), with the highest recovery from the pus. The prevalence of HLGR (51%) is higher when compared to HLSR (45-49%). Analysis of the resistance genes showed that bifunctional genes aac(6')-Ie-aph(2")-Ia and aph(3')-IIIa contributed to the HLAR E. faecalis and E. faecium. The other AME genes [aph(2")-Ib, aph(2")-Ic, aph(2")-Id] were not detected in this study.

Conclusion: This study provides the first prevalence data on HLAR and the distribution of the AME genes among E. faecalis and E. faecium isolates from Malaysia. These highlight the need for continued antibiotic surveillance to minimize its emergence and further dissemination.

Matched MeSH terms: Vancomycin Resistance

Fulltext Hospital-acquired vancomycin-resistant enterococci: now appearing in Kuala Lumpur Hospital

Zubaidah AW, Ariza A, Azmi S

Med J Malaysia, 2006 Oct;61(4):487-9.

PMID: 17243529 MyJurnal

Hospital-acquired vancomycin-resistant enterococci (VRE) were first reported in the late 1980s and have since been an increasing problem worldwide. Kuala Lumpur Hospital thus far, to the best of our knowledge has been spared from this pathogen. We describe the first confirmed case of Enterococcus faecium exhibiting the van A phenotype in our hospital, in a patient with chronic renal failure who was successfully treated with linezolid. The microbiology laboratory plays an important role in the identification and detection of VRE.

Matched MeSH terms: Vancomycin Resistance/genetics*

Comparative genome analysis of multiple vancomycin-resistant Enterococcus faecium isolated from two fatal cases

Lim SY, Yap KP, Teh CS, Jabar KA, Thong KL

Infect Genet Evol, 2017 04;49:55-65.

PMID: 28039075 DOI: 10.1016/j.meegid.2016.12.029

Enterococcus faecium is both a commensal of the human intestinal tract and an opportunistic pathogen. The increasing incidence of enterococcal infections is mainly due to the ability of this organism to develop resistance to multiple antibiotics, including vancomycin. The aim of this study was to perform comparative genome analyses on four vancomycin-resistant Enterococcus faecium (VREfm) strains isolated from two fatal cases in a tertiary hospital in Malaysia. Two sequence types, ST80 and ST203, were identified which belong to the clinically important clonal complex (CC) 17. This is the first report on the emergence of ST80 strains in Malaysia. Three of the studied strains (VREr5, VREr6, VREr7) were each isolated from different body sites of a single patient (patient Y) and had different PFGE patterns. While VREr6 and VREr7 were phenotypically and genotypically similar, the initial isolate, VREr5, was found to be more similar to VRE2 isolated from another patient (patient X), in terms of the genome contents, sequence types and phylogenomic relationship. Both the clinical records and genome sequence data suggested that patient Y was infected by multiple strains from different clones and the strain that infected patient Y could have derived from the same clone from patient X. These multidrug resistant strains harbored a number of virulence genes such as the epa locus and pilus-associated genes which could enhance their persistence. Apart from that, a homolog of E. faecalis bee locus was identified in VREr5 which might be involved in biofilm formation. Overall, our comparative genomic analyses had provided insight into the genetic relatedness, as well as the virulence potential, of the four clinical strains.

Matched MeSH terms: Vancomycin Resistance/genetics

Oxidative stress resistance and fitness-compensatory response in vancomycin-intermediate Staphylococcus aureus (VISA)

Tan XE, Neoh HM, Cui L, Hiramatsu K, Jamal R

Can J Microbiol, 2019 Aug;65(8):623-628.

PMID: 31063703 DOI: 10.1139/cjm-2019-0048

In this study, vancomycin-intermediate Staphylococcus aureus (VISA) cells carrying vraS and (or) graR mutations were shown to be more resistant to oxidative stress. Caenorhabditis elegans infected with these strains in turn demonstrated lower survival. Altered regulation in oxidative stress response and virulence appear to be physiological adaptations associated with the VISA phenotype in the Mu50 lineage.

Matched MeSH terms: Vancomycin Resistance

Fulltext Genotypic variations of virulent genes in Enterococcus faecium and Enterococcus faecalis isolated from three hospitals in Malaysia

Al-Talib H, Zuraina N, Kamarudin B, Yean CY

Adv Clin Exp Med, 2015 Jan-Feb;24(1):121-7.

PMID: 25923096 DOI: 10.17219/acem/38162

The genus Enterococcus is of increasing significance as a cause of nosocomial infections, and this trend is exacerbated by the development of antibiotic resistance.

Matched MeSH terms: Vancomycin Resistance

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