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Antimicrobial susceptibility patterns of enterococci causing infections in Europe. The European VRE Study Group
M A Schouten1, A Voss, J A Hoogkamp-Korstanje
1University Hospital St. Radboud, Department of Medical Microbiology, 6500 HB Nijmegen, The Netherlands.
Abstract:
In vitro susceptibilities of 4,208 enterococci (83% Enterococcus faecalis isolates, 13.6% Enterococcus faecium isolates, and 3.4% isolates of other species) from patients in 27 European countries towards 16 antibiotics were determined. High-level resistance to gentamicin varied by country (range, 1 to 49%; mean, 22.6% +/- 12. 3%) and per species (19.7% E. faecalis isolates, 13.6% E. faecium isolates, 3.4% by other species). Vancomycin resistance was detected in 0.06% E. faecalis, 3.8% E. faecium, and 19.1% isolates of other species. All enterococci were susceptible to LY 333328 and everninomicin, and 25% of E. faecalis isolates and 85% of other enterococci were susceptible to quinupristin-dalfopristin. The MIC of moxifloxacin and trovafloxacin for ciprofloxacin-susceptible E. faecalis at which 90% of the isolates were inhibited was 0.25 to 0.5 microg/ml.
Insights
Antibiotic resistance in enterococci varies significantly across Europe. While some antibiotics show broad efficacy, high-level resistance to gentamicin and vancomycin is a growing concern in specific enterococcal species.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Background:
- Enterococci are significant nosocomial pathogens.
- Antibiotic resistance in enterococci poses a major clinical challenge.
- Surveillance of antimicrobial susceptibility is crucial for effective treatment.
Purpose of the Study:
- To determine the in vitro antibiotic susceptibilities of a large collection of enterococcal isolates from European patients.
- To identify trends in antibiotic resistance among different enterococcal species and geographical regions.
Main Methods:
- Susceptibility testing of 4,208 enterococcal isolates against 16 antibiotics.
- Isolates were collected from patients across 27 European countries.
- Analysis of resistance patterns by species (Enterococcus faecalis, Enterococcus faecium, others) and country.
Main Results:
- High-level gentamicin resistance varied widely by country (1-49%) and species.
- Vancomycin resistance was observed in 0.06% of E. faecalis, 3.8% of E. faecium, and 19.1% of other enterococci.
- All isolates were susceptible to LY 333328 and everninomicin; notable susceptibility to quinupristin-dalfopristin was seen in other enterococci (85%).
Conclusions:
- Significant geographical and species-specific variations in enterococcal antibiotic resistance exist.
- Emerging resistance to commonly used antibiotics like gentamicin and vancomycin requires ongoing monitoring.
- Novel agents like LY 333328 and everninomicin demonstrate broad in vitro activity against these pathogens.