title: Identification of vancomycin-susceptible major clones of clinical Enterococcus from Algeria.
abstract: The main objectives of this study were to characterize clinical strains of Enterococcus spp. isolated from Algerian inpatients and outpatients, to investigate their susceptibility to antibiotics and to analyse their phylogenetic relatedness. A total of 85 non-duplicate Enterococcus spp. isolates collected between 2010 and 2013 from various clinical samples, including urine, vaginal swab, pus, blood and semen, from Algerian inpatients (n=62) and outpatients (n=23) were identified using matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF/MS). Antibiotic susceptibility testing was performed using disk diffusion and Etest methods. Clonal relatedness was analysed using multilocus sequence typing (MLST). Enterococcus faecalis was the most predominant species (75.3%), followed by Enterococcus faecium (21.2%), Enterococcus gallinarum (2.4%) and Enterococcus casseliflavus (1.2%). High-level resistance to aminoglycosides was significantly more prevalent in hospitalized patients than in outpatients. None of the E. faecalis and E. faecium isolates were resistant to vancomycin. High genetic diversity was observed among the E. faecalis isolates, with the identification of a new clonal complex (CC256), as well as the detection of E. faecalis ST6 and E. faecium lineages ST17, ST18 and ST78 associated with hospital isolates. This is the first report of E. faecalis ST6 and E. faecium ST17 and ST18 in Algeria. Although acquired vancomycin resistance was not observed among the enterococcal strains, there is a continued need to monitor the level of antibiotic resistance among enterococci as well as the evolution of the E. faecalis/E. faecium ratio.
authors.affiliation: Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM U 1905, IHU Méditérranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille Université, Marseille, France; Laboratoires de microbiologie et biochimie appliquée, Département de biochimie, Faculté des sciences, Université Badji Mokhtar-Annaba, Annaba 23000, Algeria; Département de biologie, Faculté des sciences de la nature et de la vie, Université Mohamed Cherif Messaadia de Souk Ahras, Souk Ahras, Algeria.
authors.forename: Nadjette
authors.initials: N
authors.lastname: Bourafa
authors.affiliation: Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM U 1905, IHU Méditérranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille Université, Marseille, France.
authors.forename: Cédric
authors.initials: C
authors.lastname: Abat
authors.affiliation: Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM U 1905, IHU Méditérranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille Université, Marseille, France; Laboratoire de Biotechnologie des Molécules Bioactives et de la Physiopathologie Cellulaire (LBMBPC), Faculté des sciences de la nature et de la vie, Université Batna 2, Batna, Algeria.
authors.forename: Lotfi
authors.initials: L
authors.lastname: Loucif
authors.affiliation: Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM U 1905, IHU Méditérranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille Université, Marseille, France.
authors.forename: Abiola Olumuyiwa
authors.initials: AO
authors.lastname: Olaitan
authors.affiliation: Laboratoire de microbiologie, CHU Dorban, Annaba, Algeria.
authors.forename: Ahmed Aimen
authors.initials: AA
authors.lastname: Bentorki
authors.affiliation: Laboratoires de microbiologie et biochimie appliquée, Département de biochimie, Faculté des sciences, Université Badji Mokhtar-Annaba, Annaba 23000, Algeria.
authors.forename: Nafissa
authors.initials: N
authors.lastname: Boutefnouchet
authors.affiliation: Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM U 1905, IHU Méditérranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille Université, Marseille, France. Electronic address: jean-marc.rolain@univ-amu.fr.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Rolain
mesh_terms: D000462:Algeria; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D015373:Bacterial Typing Techniques; D024881:Drug Resistance, Bacterial; D016983:Enterococcus / Q000145:classification / Q000187:drug effects*; D013293:Enterococcus faecalis; D016984:Enterococcus faecium; D005260:Female; D016908:Gram-Positive Bacterial Infections; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D058885:Multilocus Sequence Typing; D010802:Phylogeny; D014640:Vancomycin / Q000494:pharmacology*
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin
keywords: Algeria; Clonality analysis; Epidemiological features; High-risk hospital lineages