AI Article Synopsis
- The study investigates genes that cause high resistance to aminoglycosides in Enterococcus spp, which complicates treatment combinations with penicillin.
- Out of 305 resistant strains from Chile, 34.1% showed high resistance, with 93 strains possessing specific genes linked to aminoglycoside resistance.
- The research suggests that the limited occurrence of strains with extensive resistance means aminoglycoside-aminocyclitols could still be effectively used with penicillin for treating serious enterococcal infections.
Article Abstract
Background: Infectious diseases produced by Enterococcus spp, must be treated with a synergistic combination between a penicillin and an aminoglycoside. High level resistance to aminoglycosides is a serious therapeutic problem, since it predicts the loss of synergistic activity of this antimicrobial combination.
Aim: To investigate the presence of genes encoding aminoglycoside-modifying enzymes (AMEs) among strains of Enterococcus spp with high level of resistance to aminoglycosides.
Material And Methods: The genes encoding some of the AMEs were investigated among 305 aminoglycoside-resistant strains of Enterococcus spp isolated in hospitals of the VIII region of Chile, by dot blot hybridization and Polymerase Chain Reaction (PCS).
Results: High level resistance to some aminoglycosides was observed in 104 strains (34.1 %) and 93 of these harbored at least one of the genes encoding the investigated AMEs. Three genes were detected: aac(6)Ie-aph(2")Ia (14.8%) encoding for the enzyme AAC(6)Ie-APH(2")Ia (resistance to all aminoglycosides, except streptomycin); aph(3)IIIa (26%), and ant(6)la (28.5%) encoding for the phosphorylating enzymes APH(3)Ilia (resistance to kanamycin, amikacin and neomycin), and ANT(6)-la (resistance only to streptomycin), respectively. None of the strains harbored the gene ant (4) which encode for the enzyme ANT (4).
Conclusion: The low frequency of strains harbouring the bifunctional enzyme (<15%), conferring an extended resistance profile to aminoglycosides, allows us to propose the empirical use of aminoglycoside-aminocyclitols, associated to a penicillin, in the treatment of serious infections produced by species of enterococci.
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| http://dx.doi.org/10.4067/s0034-98872007000500003 | DOI Listing |
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