title: Multiplex PCR based genotypic characterization of pathogenic vancomycin resistant Enterococcus faecalis recovered from an Indian river along a city landscape.
abstract: BACKGROUND
  Enterococci are normal commensals of human gut, but vancomycin-resistant enterococci (VRE) are a severe threat to human health. Antimicrobial-resistant enterococci have been reported previously from Indian surface waters. However, the presence of antimicrobial resistance and virulence markers in Enterococcus faecalis, the most dominant enterococci is yet to be investigated.
  
  
  OBJECTIVE
  The goal of this study was to analyse concentration of enterococci and distribution of antimicrobial resistance and virulence markers in E. faecalis isolates from river waters along an important north Indian city landscape.
  
  
  METHODS
  We enumerated enterococci in river water samples (n = 60) collected from five sites across the Lucknow city landscape using the most probable number and membrane-filtration methods. The antimicrobial sensitivity profile of E. faecalis isolate was generated with the Kirby-Bauer antimicrobial disc diffusion assay. The multiplex PCR was used for genotypic characterization of vancomycin-resistance and virulence in E. faecalis isolates.
  
  
  RESULTS
  Enterococci density (p < 0.0001) increased from up-to-down-stream sites. Multiplex PCR based genotypic characterization has shown a significant distribution of virulence-markers gelE, ace or efaA in the E. faecalis isolates (p < 0.05). The range of antimicrobial-resistance varied from 5 to 12 in the landscape with the frequency of vancomycin-resistant E. faecalis (VRE) ranging from 22 to 100 %.
  
  
  CONCLUSIONS
  The occurrence of pathogenic VRE in river Gomti surface water is an important health concern. The observed high background pool of resistance and virulence in E. faecalis in river waters has the potential to disseminate more alarming antimicrobial resistance in the environment and poses serious health risk in developing countries like India as VRE infections could lead to increased cost of healthcare.
authors: CSIR-Indian Institute of Toxicology Research, PO Box 80, MG Marg, Lucknow, U.P. 226001 India.
authors: Pushpa
authors: P
authors: Lata
authors: CSIR-Indian Institute of Toxicology Research, PO Box 80, MG Marg, Lucknow, U.P. 226001 India.
authors: Siya
authors: S
authors: Ram
authors: CSIR-Indian Institute of Toxicology Research, PO Box 80, MG Marg, Lucknow, U.P. 226001 India ; Institute of Life Sciences, School of Science and Technology, Ahmedabad University, University Road, Ahmedabad, 380009 India.
authors: Rishi
authors: R
authors: Shanker
keywords: Mutiplex PCR; River water; Surface water; Vancomycin resistant E. faecalis