Antimicrobial Resistance, Biofilm Formation and Virulence Factors in Enterococcus faecalis Strains Isolated from Urinary Tract Infection in Kermanshah, Iran

Aims and Objectives: This study aims to specify the antimicrobial resistance pattern and virulence genes of Enterococcus faecalis isolated from individuals suffering from an infected urinary tract in Kermanshah, Iran. Patients and methods: Isolates were gathered from 1000 urine samples of patients diagnosed with the infected urinary tract. Biofilm assays were performed by microtiter plate test through reading the OD490 following the crystal violet staining. The Kirby–Bauer disc diffusion method was performed for the antimicrobial susceptibility testing. PCR reaction was applied to study the virulence factors. Results: Of 1000 urine samples, E. faecalis was reported 5%. Strong, moderate and weak biofilm reactions reported 80%, 12%, and 8% respectively. The most resistance reported to cotrimoxazole, vancomycin and amikacin and no resistance to nitrofurantoin were reported. Prevalence of efe A, ace, gel E, esp, cyl M, agg, cyl A and cyl B in strong biofilm formation isolates was reported 100%, 87.5%, 82.5%, 80%, 60%, 57.5% 37.5% and 30% respectively. There was a significant relationship between the frequency of efa A, ace, gel E, esp genes and strong biofilm reaction (p<0.0001). Conclusion: The presence of E. faecalis strains resistant to co-trimoxazole and vancomycin with some virulence factors is alarming the researchers. Since antibiotic resistance genes are probably transmitted among enterococci, and Staphylococci, controlling infections made by enterococci as well as the appropriate administration of antibiotics could treat the nosocomial infections effectively.