Enterococcal species distribution, antibiotic susceptibility and Van gene frequency among patients at a tertiary hospital in Sabah

Aims: Enterococcus bacteria, including some strains that are resistant to antibiotics like vancomycin can pose a threat to public health. The purpose of this study is to identify the species, antibiotic susceptibility profile and VanA/VanB gene frequencies in Enterococci isolated from patients at a tertiary hospital in Kota Kinabalu, Sabah.Methodology and results: Various bodily fluid specimens were collected from 162 patients between July 2019 and June 2021. Species confirmation and susceptibility testing were performed using an automated system. Subsequently, PCR was used to determine the presence of VanA and VanB genes. Species identification revealed the presence of five enterococcal species, namely E. faecalis (91), E. faecium (64), E. gallinarum (3) E. casseliflavus (2), along with one isolate each of E. hirae and E. avium. Overall, resistance to antibiotics like ampicillin, quinolones, tetracycline, gentamicinsyn, nitrofurantoin, glycopeptides and linezolid was generally low (<50%). However, a significant number of isolates displayed high resistance to erythromycin (>50% of samples), while resistance to tetracycline was more moderate. The frequencies of VanA and VanB genes were low (0.6 and 0%, respectively) and they were only detected in E. faecium.Conclusion, significance and impact of study: The results indicate that while the prevalence of vancomycin-resistant enterococci (VRE) may be low, there is an increasing incidence of multidrug-resistant enterococci, particularly with regards to erythromycin.