Antibiotic resistance assessment and multi-drug efflux pumps of Enterococcus faecium isolated from clinical specimens
Introduction: Enterococcus faecium is a major cause of community and hospital-acquired infections. Due to limited options for infection with fluoroquinolones-resistant Enterococci, novel therapeutics are urgently needed. Efflux pumps are contributed to fluoroquinolones resistance phenotype in this...
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The Journal of Infection in Developing Countries
2023-05-01
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| Series: | Journal of Infection in Developing Countries |
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| Online Access: | https://jidc.org/index.php/journal/article/view/17304 |
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| author | Mehdi Mirzaii Masoud Alebouyeh Mohammad Bagher Sohrabi Parisa Eslami Mojgan Fazli Maryam Ebrahimi Parinaz HajiAsgarli Marjan Rashidan |
| author_facet | Mehdi Mirzaii Masoud Alebouyeh Mohammad Bagher Sohrabi Parisa Eslami Mojgan Fazli Maryam Ebrahimi Parinaz HajiAsgarli Marjan Rashidan |
| author_sort | Mehdi Mirzaii |
| collection | DOAJ |
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Introduction: Enterococcus faecium is a major cause of community and hospital-acquired infections. Due to limited options for infection with fluoroquinolones-resistant Enterococci, novel therapeutics are urgently needed. Efflux pumps are contributed to fluoroquinolones resistance phenotype in this bacterium and novel inhibitors that target these efflux pumps could be effective in patients. In this research, the possible synergistic effect of an efflux pump inhibitor (EPI), thioridazine, with ciprofloxacin was investigated against clinical isolates of E. faecium.
Methodology: A total of 88 isolates of E. faecium from clinical specimens were studied from August 2017 to September 2018. Conventional phenotypic and molecular methods characterized all the isolates. Standard susceptibility tests and molecular assays determined the antibiotic resistance profiles and the frequency of efflux pump genes. Minimum inhibitory concentrations (MICs) to ciprofloxacin (CIP) in the presence and absence of thioridazine were measured by the micro-broth dilution method.
Results: The highest antibiotic resistance rate among E. faecium isolates was related to ciprofloxacin (96.8%), levofloxacin (94.3%), and imipenem (90.9%), respectively. The highest frequency of efflux pump determinants was related to efmA (60, 68%), followed by emeA (48, 54.5%), and efrA and/or efrB genes (45, 51%). The efflux pump inhibitor showed ≥ 2-fold decrease in the MIC value of ciprofloxacin in 48.2% of the isolates.
Conclusions: Efflux pump inhibitor genes efrAB, efmA, and emeA are common among the E. faecium clinical isolates. Our results supported the administration of thioridazine, as an efflux pump inhibitor, in fluoroquinolone-resistant E. faecium infections due to its synergistic effect with CIP.
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| format | Article |
| id | doaj-art-a90bccccef924a83b796edc1ed94cada |
| institution | OA Journals |
| issn | 1972-2680 |
| language | English |
| publishDate | 2023-05-01 |
| publisher | The Journal of Infection in Developing Countries |
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| series | Journal of Infection in Developing Countries |
| spelling | doaj-art-a90bccccef924a83b796edc1ed94cada2025-08-20T02:27:22ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802023-05-01170510.3855/jidc.17304Antibiotic resistance assessment and multi-drug efflux pumps of Enterococcus faecium isolated from clinical specimensMehdi Mirzaii0Masoud Alebouyeh1Mohammad Bagher Sohrabi2Parisa Eslami3Mojgan Fazli4Maryam Ebrahimi5Parinaz HajiAsgarli6Marjan Rashidan7Department of Microbiology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, IranPediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, IranSchool of Medicine, Shahroud University of Medical Sciences, Shahroud, IranDepartment of Microbiology, Milad Hospital, Tehran, IranDepartment of Microbiology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, IranDepartment of Microbiology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, IranStudent research committee, school of medicine, Shahroud University of Medical Sciences, Shahroud, IranDepartment of Microbiology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran Introduction: Enterococcus faecium is a major cause of community and hospital-acquired infections. Due to limited options for infection with fluoroquinolones-resistant Enterococci, novel therapeutics are urgently needed. Efflux pumps are contributed to fluoroquinolones resistance phenotype in this bacterium and novel inhibitors that target these efflux pumps could be effective in patients. In this research, the possible synergistic effect of an efflux pump inhibitor (EPI), thioridazine, with ciprofloxacin was investigated against clinical isolates of E. faecium. Methodology: A total of 88 isolates of E. faecium from clinical specimens were studied from August 2017 to September 2018. Conventional phenotypic and molecular methods characterized all the isolates. Standard susceptibility tests and molecular assays determined the antibiotic resistance profiles and the frequency of efflux pump genes. Minimum inhibitory concentrations (MICs) to ciprofloxacin (CIP) in the presence and absence of thioridazine were measured by the micro-broth dilution method. Results: The highest antibiotic resistance rate among E. faecium isolates was related to ciprofloxacin (96.8%), levofloxacin (94.3%), and imipenem (90.9%), respectively. The highest frequency of efflux pump determinants was related to efmA (60, 68%), followed by emeA (48, 54.5%), and efrA and/or efrB genes (45, 51%). The efflux pump inhibitor showed ≥ 2-fold decrease in the MIC value of ciprofloxacin in 48.2% of the isolates. Conclusions: Efflux pump inhibitor genes efrAB, efmA, and emeA are common among the E. faecium clinical isolates. Our results supported the administration of thioridazine, as an efflux pump inhibitor, in fluoroquinolone-resistant E. faecium infections due to its synergistic effect with CIP. https://jidc.org/index.php/journal/article/view/17304Enterococcus faeciumefflux pumpsantibiotic resistancethioridazine |
| spellingShingle | Mehdi Mirzaii Masoud Alebouyeh Mohammad Bagher Sohrabi Parisa Eslami Mojgan Fazli Maryam Ebrahimi Parinaz HajiAsgarli Marjan Rashidan Antibiotic resistance assessment and multi-drug efflux pumps of Enterococcus faecium isolated from clinical specimens Journal of Infection in Developing Countries Enterococcus faecium efflux pumps antibiotic resistance thioridazine |
| title | Antibiotic resistance assessment and multi-drug efflux pumps of Enterococcus faecium isolated from clinical specimens |
| title_full | Antibiotic resistance assessment and multi-drug efflux pumps of Enterococcus faecium isolated from clinical specimens |
| title_fullStr | Antibiotic resistance assessment and multi-drug efflux pumps of Enterococcus faecium isolated from clinical specimens |
| title_full_unstemmed | Antibiotic resistance assessment and multi-drug efflux pumps of Enterococcus faecium isolated from clinical specimens |
| title_short | Antibiotic resistance assessment and multi-drug efflux pumps of Enterococcus faecium isolated from clinical specimens |
| title_sort | antibiotic resistance assessment and multi drug efflux pumps of enterococcus faecium isolated from clinical specimens |
| topic | Enterococcus faecium efflux pumps antibiotic resistance thioridazine |
| url | https://jidc.org/index.php/journal/article/view/17304 |
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