title: Characteristics of Vancomycin-Resistant Enterococcus Strains in the West Balkans: A First Report.
abstract: Vancomycin-resistant enterococci are among the major causes of nosocomial infections and represent a growing problem in many European countries. Among the most common enterococcal isolates, Enterococcus faecium is considered to be the reservoir of VanA and VanB-mediated resistance to glycopeptides. Enterococci with VanA-mediated resistance can transfer resistance genes to other enterococci and gram-positive bacteria. Hence, monitoring and surveillance of vancomycin-resistant enterococci (VREs) are crucial for the prevention of the spread of glycopeptide resistance. No reports have yet been published that document the resistance rates and typization of VREs in the region of Bosnia and Herzegovina as well as Croatia. In this study, 64 clinical enterococcal strains that were isolated in clinical centers, Mostar, Sarajevo, and Zagreb, were studied and findings regarding characteristics of vancomycin-resistant strains found in the West Balkan region are reported for the first time. All of the strains were identified using conventional phenotypic methods, and the resistance to glycopeptides was determined using the disk diffusion method, Vitek 2, and genotypic Enterococcus assay. The results of genotyping showed that 40 strains were identified as VREs (30% Enterococcus faecalis and 70% E. faecium), while the sensitivity of the phenotypic methods was 87.5%. Furthermore, VanA and VanB resistance types were found in Bosnia and Herzegovina and Croatia, with slightly higher prevalence of the latter (72.5%) over the former (27.5%).
authors.affiliation: 1 Institute for Microbiology and Molecular Diagnostics, University Clinical Hospital , Mostar, Bosnia and Herzegovina.
authors.forename: Sanja
authors.initials: S
authors.lastname: Jakovac
authors.affiliation: 2 Department of Genetics and Bioengineering, International Burch University , Sarajevo, Bosnia and Herzegovina.
authors.forename: Elma Ferić
authors.initials: EF
authors.lastname: Bojić
authors.affiliation: 2 Department of Genetics and Bioengineering, International Burch University , Sarajevo, Bosnia and Herzegovina.
authors.forename: Monia Avdić
authors.initials: MA
authors.lastname: Ibrišimović
authors.affiliation: 1 Institute for Microbiology and Molecular Diagnostics, University Clinical Hospital , Mostar, Bosnia and Herzegovina.
authors.forename: Borka
authors.initials: B
authors.lastname: Tutiš
authors.affiliation: 1 Institute for Microbiology and Molecular Diagnostics, University Clinical Hospital , Mostar, Bosnia and Herzegovina.
authors.forename: Maja
authors.initials: M
authors.lastname: Ostojić
authors.affiliation: 2 Department of Genetics and Bioengineering, International Burch University , Sarajevo, Bosnia and Herzegovina.|3 Institute for Biomedical Research and Diagnostics NALAZ , Sarajevo, Bosnia and Herzegovina.|4 Academy of Sciences and Arts of Bosnia and Herzegovina , Sarajevo, Bosnia and Herzegovina.
authors.forename: Mirsada
authors.initials: M
authors.lastname: Hukić
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics / Q000378:metabolism; D015373:Bacterial Typing Techniques; D017522:Bosnia and Herzegovina / Q000453:epidemiology; D019729:Carbon-Oxygen Ligases / Q000235:genetics / Q000378:metabolism; D017523:Croatia / Q000453:epidemiology; D013293:Enterococcus faecalis / Q000187:drug effects / Q000235:genetics* / Q000254:growth & development / Q000302:isolation & purification; D016984:Enterococcus faecium / Q000187:drug effects / Q000235:genetics* / Q000254:growth & development / Q000302:isolation & purification; D015964:Gene Expression Regulation, Bacterial; D022761:Gene Transfer, Horizontal; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D006801:Humans; D008826:Microbial Sensitivity Tests; D010865:Pilot Projects; D010957:Plasmids / Q000737:chemistry / Q000378:metabolism; D011446:Prospective Studies; D062486:Public Health Surveillance; D014640:Vancomycin / Q000494:pharmacology; D020713:Vancomycin Resistance / Q000235:genetics*; D065507:Vancomycin-Resistant Enterococci / Q000187:drug effects / Q000235:genetics* / Q000254:growth & development / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; C071437:VanA ligase, Bacteria; C079913:VanB protein, Enterococcus; D014640:Vancomycin; D019729:Carbon-Oxygen Ligases
keywords: Enterococcus; VRE; genotyping; resistance