| Department of Ophthalmology, College of Medicine, Kosin University , Busan, Korea(1)
Department of Microbiology, College of Medicine, Kosin University , Busan, Korea(1) |
| Gwang Myeong Noh(1), MD, Bo Hyun Jeong(2), MS, Indal Park(2), MD, PhD, Seunguk Lee(1), MD, PhD, Sang Joon Lee(1), MD, PhD |
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Purpose : The emergence of quinolone resistant Enterococci is worldwide. Genotyping, quinolone- resistance and virulence factor genes of Enterococcus faecalis isolated from ocular area were analyzed.
Methods : From April 1, 2014 to September 31, 2017, 16 strains of E. faecalis were identified in 374 eyes out of 187 patients who underwent cataract surgery, intravitreal injection, and vitrectomy. Among these, strains showing resistance to ciprofloxacin, levofloxacin, and moxifloxacin were identified by stair-dilution method. The presence of virulence factors such as esp, hyl, efba, asa1, ace, cylA, and gelE was analyzed by extracting the DNA of the strain. Mutations were confirmed by sequencing of the gyrA and parC genes of the quinolone resistant determining region (QRDR) involved in tolerance.
Results : Of the 16 strains, 43.8%(7/16) were resistant to quinolone antibiotics. The virulence factors efba, asa1, ace, cylA, and gelE were present in all strains. GyrA and parC genes were present in all identified isolates, and mutations were observed in 84 amino acid residues of gyrA and 82, 86, 89 amino acid residues of parC.
Conclusion : Increased resistance to quinolone antibiotics in E. faecalis identified in the eye is thought to be not associated with the virulence factors efba, asa1, ace, cylA, and gelE genes. The increase in resistance to quinolone antibiotics seems to be related to the presence of mutations in both gyrA and parC genes.
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