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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Russian Journal of Infection and Immunity</journal-id><journal-title-group><journal-title xml:lang="en">Russian Journal of Infection and Immunity</journal-title><trans-title-group xml:lang="ru"><trans-title>Инфекция и иммунитет</trans-title></trans-title-group></journal-title-group><issn publication-format="print">2220-7619</issn><issn publication-format="electronic">2313-7398</issn><publisher><publisher-name xml:lang="en">SPb RAACI</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">17642</article-id><article-id pub-id-type="doi">10.15789/2220-7619-ARP-17642</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>ORIGINAL ARTICLES</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ СТАТЬИ</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Antimicrobial resistance patterns and virulence determinants of clinical enterococcus isolates in Pakistan</article-title><trans-title-group xml:lang="ru"><trans-title>Структура устойчивости к антимикробным препаратам и факторы вирулентности клинических изолятов энтерококка в Пакистане</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Ullah</surname><given-names>J.</given-names></name><name xml:lang="ru"><surname>Улла</surname><given-names>Д.</given-names></name></name-alternatives><address><country country="PK">Pakistan</country></address><bio xml:lang="en"><p>MPhil Scholar, Department of Medical Laboratory Technology, Faculty of Basic &amp; Applied Sciences</p></bio><bio xml:lang="ru"><p>магистр философии, преподаватель, кафедра медицинских лабораторных технологий, факультет фундаментальных и прикладных наук</p></bio><email>ihsan.ipms@kmu.edu.pk</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Aziz</surname><given-names>A.</given-names></name><name xml:lang="ru"><surname>Азиз</surname><given-names>А.</given-names></name></name-alternatives><address><country country="PK">Pakistan</country></address><bio xml:lang="en"><p>MPhil Lecturer, Department of Medical Laboratory Technology, Faculty of Basic &amp; Applied Sciences</p></bio><bio xml:lang="ru"><p>магистр философии, преподаватель, кафедра медицинских лабораторных технологий, факультет фундаментальных и прикладных наук</p></bio><email>ihsan.ipms@kmu.edu.pk</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Ullah</surname><given-names>A.</given-names></name><name xml:lang="ru"><surname>Улла</surname><given-names>А.</given-names></name></name-alternatives><address><country country="PK">Pakistan</country></address><bio xml:lang="en"><p>MPhil Scholar, Department of Medical Laboratory Technology, Faculty of Basic &amp; Applied Sciences</p></bio><bio xml:lang="ru"><p>магистр философии, преподаватель, кафедра медицинских лабораторных технологий, факультет фундаментальных и прикладных наук</p></bio><email>ihsan.ipms@kmu.edu.pk</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Ullah</surname><given-names>I.</given-names></name><name xml:lang="ru"><surname>Улла</surname><given-names>И.</given-names></name></name-alternatives><address><country country="PK">Pakistan</country></address><bio xml:lang="en"><p>MPhil Scholar, Department of Medical Laboratory Technology, Faculty of Basic &amp; Applied Sciences</p></bio><bio xml:lang="ru"><p>магистр философии, преподаватель, кафедра медицинских лабораторных технологий, факультет фундаментальных и прикладных наук</p></bio><email>ihsan.ipms@kmu.edu.pk</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Jabbar</surname><given-names>A.</given-names></name><name xml:lang="ru"><surname>Джаббар</surname><given-names>А.</given-names></name></name-alternatives><bio xml:lang="en"><p>Assistant Professor, Department of Medical Laboratory Technology, Faculty of Basic &amp; Applied Sciences</p></bio><bio xml:lang="ru"><p>ассистент, кафедра медицинских лабораторных технологий, факультет фундаментальных и прикладных наук</p></bio><email>ihsan.ipms@kmu.edu.pk</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Umair</surname><given-names>M.</given-names></name><name xml:lang="ru"><surname>Умейр</surname><given-names>М.</given-names></name></name-alternatives><address><country country="PK">Pakistan</country></address><bio xml:lang="en"><p>MPhil Scholar, Institute of Paramedical Sciences (IPMS)</p></bio><bio xml:lang="ru"><p>магистр философии, преподаватель, Институт парамедицинских наук (IPMS)</p></bio><email>ihsan.ipms@kmu.edu.pk</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Ullah</surname><given-names>M.</given-names></name><name xml:lang="ru"><surname>Улла</surname><given-names>М.</given-names></name></name-alternatives><bio xml:lang="en"><p>Assistant Professor</p></bio><bio xml:lang="ru"><p>ассистент</p></bio><email>ihsan.ipms@kmu.edu.pk</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Ullah</surname><given-names>H.</given-names></name><name xml:lang="ru"><surname>Улла</surname><given-names>Х.</given-names></name></name-alternatives><address><country country="PK">Pakistan</country></address><bio xml:lang="en"><p>MBBS, Trainee Medical Officer</p></bio><bio xml:lang="ru"><p>магистр философии, преподаватель</p></bio><email>ihsan.ipms@kmu.edu.pk</email><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Ullah</surname><given-names>M.</given-names></name><name xml:lang="ru"><surname>Улла</surname><given-names>М.</given-names></name></name-alternatives><address><country country="PK">Pakistan</country></address><bio xml:lang="en"><p>MPhil Lecturer</p></bio><bio xml:lang="ru"><p>магистр философии, преподаватель</p></bio><email>ihsan.ipms@kmu.edu.pk</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Ali</surname><given-names>Ihsan</given-names></name><name xml:lang="ru"><surname>Али</surname><given-names>Ихсан</given-names></name></name-alternatives><address><country country="PK">Pakistan</country></address><bio xml:lang="en"><p>Assistant Professor in the Department of Medical Laboratory Technology, Institute of Paramedical Sciences (IPMS)</p></bio><bio xml:lang="ru"><p id="tw-target-text">доцент кафедры медицинских лабораторных технологий, Институт парамедицинских наук (IPMS)</p></bio><email>ihsan.ipms@kmu.edu.pk</email><xref ref-type="aff" rid="aff2"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">The University of Haripur</institution></aff><aff><institution xml:lang="ru">Университет Харипура</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Khyber Medical University</institution></aff><aff><institution xml:lang="ru">Хайберский медицинский университет</institution></aff></aff-alternatives><aff-alternatives id="aff3"><aff><institution xml:lang="en">Saidu Group of Teaching Hospitals</institution></aff><aff><institution xml:lang="ru">Группа Сайду клинической больницы</institution></aff></aff-alternatives><pub-date date-type="preprint" iso-8601-date="2024-08-02" publication-format="electronic"><day>02</day><month>08</month><year>2024</year></pub-date><pub-date date-type="pub" iso-8601-date="2024-12-21" publication-format="electronic"><day>21</day><month>12</month><year>2024</year></pub-date><volume>14</volume><issue>5</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>995</fpage><lpage>1001</lpage><history><date date-type="received" iso-8601-date="2024-05-04"><day>04</day><month>05</month><year>2024</year></date><date date-type="accepted" iso-8601-date="2024-07-28"><day>28</day><month>07</month><year>2024</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2024, Ullah J., Aziz A., Ullah A., Ullah I., Jabbar A., Umair M., Ullah M., Ullah H., Ullah M., Ali I.</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2024, Улла Д., Азиз А., Улла А., Улла И., Джаббар А., Умейр М., Улла М., Улла Х., Улла М., Али И.</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="en">Ullah J., Aziz A., Ullah A., Ullah I., Jabbar A., Umair M., Ullah M., Ullah H., Ullah M., Ali I.</copyright-holder><copyright-holder xml:lang="ru">Улла Д., Азиз А., Улла А., Улла И., Джаббар А., Умейр М., Улла М., Улла Х., Улла М., Али И.</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://iimmun.ru/iimm/article/view/17642">https://iimmun.ru/iimm/article/view/17642</self-uri><abstract xml:lang="en"><p><italic>Background.</italic> The current study was designed to determine antibiotic resistance profile,detection of antimicrobial resistance and virulence-related genes among enterococcus species. <italic>Materials and methods.</italic> Altogether, one hundred fifty enterococcal isolates were collected from various clinical specimens and identified by Polymerase chain reaction (PCR). Antibiotic susceptibility testing and MICs of vancomycin were carried out as per CLSI guidelines. A series of PCR reactions were used to screen vancomycin-resistant genes <italic>(vanA</italic>, <italic>vanB</italic>, and <italic>vanD)</italic> and virulence-related genes <italic>(esp, ace, asa1, gelE </italic>&amp;<italic> cylA)</italic> among VRE enterococcus species. <italic>Results.</italic> The isolated enterococcal strains comprised 62.6% <italic>E. faecalis</italic>, 33.4% <italic>E. faecium</italic>, and 4% of other species. Overall enterococcus showed a high level of resistance; 94% to erythromycin, followed by ciprofloxacin 82.6%, levofloxacin 70%, and vancomycin 16%. The 57.4% of the isolates were recovered from hospitalized patients and 96% of the enterococcus isolates were multi-drug resistant. The MICs of vancomycin-resistant strains remained in the range of 32 µg/ml to 256 µg/ml for the majority of the isolates. The vancomycin-resistant phenotypes <italic>vanA</italic>, <italic>vanB</italic>, and <italic>vanD</italic> were found in 29.2%, 37.5%, and 33.3% isolates respectively. Regarding virulence determinants the observed percentages were as follows; <italic>esp</italic>: 16.6%, <italic>asa1</italic>: 70.8%, <italic>gelE</italic>: 25%, <italic>ace</italic>: 33.3%, and <italic>cylA</italic>: 25%. <italic>Conclusion.</italic> The majority of the isolates were <italic>E. faecalis</italic> and multi-drug resistant. The VRE isolates carried antimicrobial resistance and virulence-related genes, and <italic>vanA</italic>, B, D phenotypes were the most common among VRE isolates.</p></abstract><trans-abstract xml:lang="ru"><p>Настоящее исследование было разработано для определения у разных видов энтерококков профиля устойчивости к антибиотикам, выявления устойчивости к противомикробным препаратам и генов, связанных с вирулентностью. <italic>Материалы и методы.</italic> Всего было собрано 150 изолятов энтерококков из различных клинических образцов. Эти изоляты были идентифицированных с помощью полимеразной цепной реакции (ПЦР). Тестирование чувствительности к антибиотикам и определение минимальной ингибирующей концентрации (МИК) ванкомицина проводились в соответствии с рекомендациями Института клинических и лабораторных стандартов (CLSI). Серия реакций ПЦР использовалась для скрининга генов устойчивости к ванкомицину <italic>(</italic><italic>vanA</italic>, <italic>vanB</italic> и <italic>vanD</italic><italic>)</italic> и генов вирулентности <italic>(</italic><italic>esp</italic>, <italic>ace</italic>, <italic>asa</italic><italic>1</italic>, <italic>gelE</italic> и <italic>cylA</italic><italic>)</italic> среди видов ванкомицинрезистентных энтерококков (ВРЭ). <italic>Результаты.</italic> Выделенные штаммы энтерококков включали 62,6% <italic>E</italic><italic>. </italic><italic>faecalis</italic>, 33,4% <italic>E</italic><italic>. </italic><italic>faecium</italic> и 4% других видов. В целом энтерококки показали высокий уровень устойчивости: 94% — к эритромицину, за которым следуют ципрофлоксацин (82,6%), левофлоксацин (70%) и ванкомицин (16%). 57,4% изолятов были получены от госпитализированных пациентов, 96% изолятов энтерококков имели множественную лекарственную устойчивость. МИК для ВРЭ штаммов большинства изолятов варьировали в диапазоне от 32 мкг/мл до 256 мкг/мл. ВРЭ фенотипы в виде <italic>vanA</italic>, <italic>vanB</italic> и <italic>vanD</italic> были обнаружены у 29,2%, 37,5% и 33,3% изолятов соответственно. В отношении факторов вирулентности, получены следующие распределения: <italic>esp</italic> — 16,6%, <italic>asa</italic><italic>1</italic> — 70,8%, <italic>gelE</italic> — 25%, <italic>ace</italic> — 33,3% и <italic>cylA</italic> — 25%. <italic>Заключение.</italic> Большинство изолятов были <italic>E</italic><italic>. </italic><italic>faecalis</italic> и имели множественную лекарственную устойчивость. ВРЭ изоляты несли гены устойчивости к противомикробным препаратам и гены, связанные с вирулентностью, а фенотипы <italic>vanA</italic><italic>, </italic><italic>vanB</italic><italic>, </italic><italic>vanD</italic> были наиболее распространены среди ВРЭ изолятов.</p></trans-abstract><kwd-group xml:lang="en"><kwd>antimicrobial resistance</kwd><kwd>Enterococcus</kwd><kwd>minimum inhibitory concentration</kwd><kwd>vancomycin resistant enterococci</kwd><kwd>virulence factors</kwd><kwd>antimicrobial resistance gene</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>устойчивость к противомикробным препаратам</kwd><kwd>энтерококки</kwd><kwd>минимальная ингибирующая концентрация</kwd><kwd>ванкомицинрезистентные энтерококки</kwd><kwd>факторы вирулентности</kwd><kwd>ген устойчивости к противомикробным препаратам</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Ahmed M.O., Baptiste K.E. 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