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Phenotypic and Genotypic Variations of Enterococcus Spp

Phenotypic and Genotypic Variations of Enterococcus Spp. Isolated From Patients With Hospital Acquired Infections in Sohag University Hospitals, Egypt

Status
UNKNOWN
Phases
Unknown
Study type
Observational
Source
ClinicalTrials.gov
Registry ID
NCT05751317
Enrollment
100
Registered
2023-03-02
Start date
2023-04-01
Completion date
2024-03-30
Last updated
2023-04-19

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Isolation of Enterococci From Samples, Demonstration of Enterococci Antibiotic Susceptibility, Detection of Strains Enterococci Produce Biofilm, Studying Effect of Nanoparticles on Enterococci Antimicrobial Resistance, Studying Effect of Nanoparticles on Enterococci Biofilm, Genotyping of Enterococci

Keywords

phenotypic, genotypic, Enterococci, biofilm

Brief summary

Enterococci are Gram-positive facultative anaerobic cocci arranged in short and medium chains. Enterococci reside in the gastrointestinal tract and usually function commensally with humans. They can, however, cause several infections, such as urinary tract infections (UTIs), intra-abdominal infection, bacteremia, or endocarditis. Among many species identified, E. faecalis and E. faecium are the most common species capable of causing infection and posing a threat of antimicrobial resistance, with E. faecalis accounting for the majority of infections.

Detailed description

Enterococci are Gram-positive facultative anaerobic cocci arranged in short and medium chains. Enterococci reside in the gastrointestinal tract and usually function commensally with humans. They can, however, cause several infections, such as urinary tract infections (UTIs), intra-abdominal infection, bacteremia, or endocarditis. Among many species identified, E. faecalis and E. faecium are the most common species capable of causing infection and posing a threat of antimicrobial resistance, with E. faecalis accounting for the majority of infections. Pathogenic species of enterococci express many virulence factors such as adhesins, gelatinase, Enterococcus surface protein, aggregation substances and cytolysins along with biofilm formation. These factors enhance the ability of the pathogen to invade, attach and survive through the acquisition of nutrients in the host tissue. Their presence in drug resistant strains increases the severity of the infection Enterococci are intrinsically resistant to antibiotics such as aminoglycosides and β-lactam-based antibiotics. Moderate resistance to aminoglycosides is due to the intrinsic low permeability of the enterococcal cell wall to the large aminoglycoside molecules and is more prevalent in E. faecium than E. faecalis. Intrinsic β-lactam resistance is due to the overexpression of penicillin-binding proteins with low affinity for β-lactams, which makes E. faecalis more resistant to penicillin than E. faecium Moreover, enterococci can readily acquire resistance to antimicrobials, and vancomycin-resistant enterococci (VRE) are among the priority pathogens for which new antibiotics are needed. In addition, biofilm formation is one of the strategies for the enterococci to evade the host's immune response and the inhibitory or killing effects of antibiotics. This self-produced extracellular matrix also provides a suitable microenvironment for enterococci to grow and facilitates the transmission of mobile genetic elements (MGEs) between bacteria. Enterococcal biofilms have been implicated in indwelling device-related infections such as prosthetic valve endocarditis, prosthetic joint infections and catheter-related infections. Biofilm forming bacteria show resistance to many antibiotics and immune response which results in treatment failure. Given the difficulty of treating and eradicating biofilm associated infections, there is an unmet need for therapeutic options other than antibiotics to prevent biofilm formation. Nanoparticles are attracting attention given their very small size and various antibacterial properties. Nanoparticles can interact with bacteria per unit area, which can make the antibacterial activity of nanoparticles more powerful. Nanoparticles can also initiate several bactericidal pathways, such as disrupting the bacterial membrane and release of intracellular components, making it difficult for bacteria to become resistant.

Interventions

DIAGNOSTIC_TESTCulture

* Samples will be transported to Medical Microbiology and Immunology Laboratory and will be inoculated on MacConkey medium. * Pink colonies will be inoculated on bile esculin agar medium. * Enterococci produce blackening of the agar

DIAGNOSTIC_TESTStaining:

The growing colonies on bile esculin agar medium will be examined microscopically after staining by Gram stain.

DIAGNOSTIC_TESTBiochemical reactions:

* Catalase test. * Salt tolerance test

DIAGNOSTIC_TESTVITEK

Automated identification of Enterococci will be done with VITEK2 system.

Strains confirmed as Enterococci will be examined for their antibiotic susceptibility by modified Kirby Bauer's disc diffusion method on Mueller-Hinton Agar.

DIAGNOSTIC_TESTnanoparticles effect

The effect of nanoparticles on Enterococci antimicrobial resistance pattern

DIAGNOSTIC_TESTThe biofilm formation activity

The biofilm formation activity of Enterococci isolates will be tested using the microtiter plate technique

DIAGNOSTIC_TESTmolecular diagnosis

Molecular identification of some virulence factors genes and antibiotic resistance genes of Enterococci using PCR

Sponsors

Sohag University
Lead SponsorOTHER

Study design

Observational model
CASE_CONTROL
Time perspective
CROSS_SECTIONAL

Eligibility

Sex/Gender
ALL
Age
1 Months to 90 Years

Inclusion criteria

* All patients suffering from infections that can be caused by Enterococci.

Exclusion criteria

* All patients suffering from infections that aren't caused by Enterococci

Design outcomes

Primary

MeasureTime frameDescription
Isolation and identification of Enterococci from different clinical samplesfrom April 2023 to December 2023Isolation and identification of Enterococci from different clinical samples (pus, urine, urinary catheter samples, stool, wound swabs, sputum, central venous catheter samples) will be collected under aseptic precautions from patients admitted at different departments at Sohag university hospitals.
Demonstration of Enterococci antibiotic susceptibility profilefrom April 2023 to December 2023Strains confirmed as Enterococci will be examined for their antibiotic susceptibility by modified Kirby Bauer's disc diffusion method on Mueller-Hinton Agar.
Detection of strains of Enterococci which produce biofilmfrom April 2023 to December 2023The biofilm formation activity of Enterococci isolates will be tested using the microtiter plate technique
Studying the effect of nanoparticles on Enterococci antimicrobial resistance patternfrom April 2023 to December 2023Inhibition zones of all groups will be compared to detect the effect of nanoparticles on Enterococci antimicrobial resistance pattern.
Studying the effect of nanoparticles on Enterococci biofilm producing abilityfrom December 2023 to March 2024The effect of nanoparticles on Enterococci biofilm producing ability
Genotypic characterization of Enterococci.rom December 2023 to March 2024Molecular identification of some virulence factors genes and antibiotic resistance genes of Enterococci using polymerase chain reaction.

Countries

Egypt

Contacts

Primary ContactMai G Abbas, Demonstrator
maigamal@med.sohag.edu.eg01068298408
Backup ContactNoha S Shafik, Lecturer
nohasaber@med.sohag.edu.eg01067261504

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026