Antimicrobial Resistance and Virulence Determination of Enterococcus spp. isolated from Hospital Environment in Iran

Abstract Background: The role of the hospital environment as a source of pathogenic bacteria in recent studies has been poorly investigated. This study investigated the distribution of antimicrobial resistance genes and virulence determinants in Enterococcus species isolated from hospital environment in Sari, Iran. A total of 90 enterococci isolates were identified and species identification confirmed with specific primers. Seven resistance genes and two virulence associated genes were evaluated molecularly by multiplex polymerase chain reaction. Results: Of the 90 enterococcal isolates, 42 (46.66%), and 48 (53.33%) were identified as E. faecalis, and E. faecium, respectively. Also, 28 (66.6%) E. faecalis and 18 (37.5%) E. faecium isolates were multidrug-resistant (MDR). Among all 90 environmental isolates 54 (60%), 54 (60%), 8 (8.8%), 8 (8.8%), 60 (66.6%), 26 (28.8%), and 24 (26.6%) isolates contained tetM, tetL, vanA, vanB, ermB, aac (6´)-Ie-aph (2´´)-Ia, and aph (3´)-IIIa, respectively. Moreover, 88 (97.7%) and 16 (17.7%) isolates were detected as esp and ace positive ones, correspondingly. Conclusions: This report showed that the environmental isolates of Enterococcus are the major sources of antibiotic resistance genes that can transfer them to the clinical isolates of bacteria in hospital settings. An effective following strategy should be organized to clearance and stop emergence of these pathogenic bacteria.