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Updated: Sep 22, 2025
A Duplex Digital PCR Assay for Simultaneous Quantification of the Enterococcus spp. and the Human Fecal-associated HF183 Marker in Waters
Published on: March 9, 2016
First detection of vanA positive Enterococcus faecium clonal complex 17 in hospital wastewater in Algeria: an
Z Cherak1,2, E Bendjama3,4, A Moussi1
1Laboratoire de Génétique, Biotechnologie et Valorisation des Bio-ressources (GBVB), Faculté des Sciences Exactes et des Sciences de La Nature et de La Vie, Université Mohamed Khider, Biskra, Algeria.
Abstract:
Enterococcus spp. are Gram-positive cocci that are recognised as critical opportunistic pathogens, especially in immunocompromised patients. Vancomycin is considered as the drug of last resort for the treatment of infections caused by Enterococcus species, making vancomycin resistance a serious public health concern. In this article, we report the first environmental vanA positive Enterococcus faecium isolates in Algeria. The strains were selectively isolated from hospital wastewater and then identified using matrix-assisted laser desorption and ionisation time-of-flight mass spectrometry. Antibiotic susceptibility testing was performed using the disc diffusion method. Vancomycin resistance genes were searched for by standard PCR and the clonal relatedness of our isolates was investigated by multilocus sequence typing. A total of five highly vancomycin-resistant Gram-positive bacteria were isolated and identified as Enterococcus faecium. The isolates harboured the vanA gene and were assigned to the clonal complex 17. Our findings confirm the great potential of hospital wastewater as a reservoir and dissemination pathway of multidrug resistant organisms, and alert to the need for better regulation of hospital waste management in order to reduce their impact on the environment.
Insights
The first environmental vancomycin-resistant Enterococcus faecium strains carrying the vanA gene were identified in Algerian hospital wastewater. This highlights the urgent need for improved hospital waste management to curb the spread of antibiotic resistance.
Area of Science:
- Microbiology
- Environmental Science
- Public Health
Background:
- Enterococcus species are critical opportunistic pathogens, particularly in immunocompromised individuals.
- Vancomycin resistance in Enterococcus is a significant public health concern, as vancomycin is a last-resort antibiotic.
- Hospital wastewater can serve as a reservoir for multidrug-resistant organisms.
Purpose of the Study:
- To report the first isolation of environmental vanA-positive Enterococcus faecium in Algeria.
- To investigate the characteristics and clonal relatedness of these resistant isolates.
- To assess the role of hospital wastewater in the dissemination of antibiotic resistance.
Main Methods:
- Selective isolation of bacteria from hospital wastewater.
- Identification of isolates using matrix-assisted laser desorption and ionisation time-of-flight mass spectrometry (MALDI-TOF MS).
- Antibiotic susceptibility testing (disc diffusion), vanA gene detection (PCR), and multilocus sequence typing (MLST).
Main Results:
- Five highly vancomycin-resistant Enterococcus faecium isolates were recovered from hospital wastewater.
- All isolates harbored the vanA gene, conferring vancomycin resistance.
- The isolates belonged to clonal complex 17, indicating potential for clonal spread.
Conclusions:
- Hospital wastewater is a significant reservoir and dissemination route for multidrug-resistant organisms.
- The presence of vanA-positive Enterococcus faecium underscores the need for stringent hospital waste management regulations.
- Environmental surveillance is crucial for monitoring and controlling the spread of antibiotic resistance.
