Antimicrobial resistance in Enterococcus spp. is a growing public health challenge. This study mapped resistance genes in Enterococcus in Brazil, considering different origins and contexts. Systematic review in PubMed using the descriptors “Enterococcus AND Brazil AND resistance genes” from the first published article (1999) through December 2024, including studies with molecular identification of genes by PCR or sequencing, excluding phenotypic profiling. One hundred fifteen studies were found; after screening, 59 articles were included. Most addressed clinical isolates (37). Isolates of animal origin (10), environmental origin (7), and food origin (5) were also found, indicating that antimicrobial resistance may be disseminated across these contexts. All Brazilian regions had publications, except the North region, which had no PubMed-indexed publications. For glycopeptides, vanA was the main gene identified in environmental isolates (DF, PE), clinical isolates (PR, RS, MG, RJ, SP), and food isolates (MG). The vanB gene was rarer, with reports only in CE, MG, and RJ. The vanC1 gene was found in DF, RJ, and SP, and vanD in PR. Reports of linezolid resistance (cfr gene) were found in DF, PR, SC, and in SP with optrA. The gyrA and parC genes, associated with fluoroquinolones, were reported in RJ in isolates of animal origin. The vat(D) and sat-4 genes, conferring resistance to streptogramin A, were found in RJ in isolates of animal origin. Genes conferring resistance to aminoglycosides, macrolides, lincosamides, streptogramin B, sulfonamides, trimethoprim, and tetracyclines were widely reported across all contexts and species. In MG, resistance genes in food isolates related to antiseptics, disinfectants, and quaternary ammonium compounds were reported. There were no reports of resistance genes to lipopeptides or tigecycline. A broad dissemination of resistance genes in Enterococcus across different origins, species, and contexts in Brazil was evidenced, highlighting the need to strengthen surveillance, especially in the North region of the country. Molecular surveillance is essential to establish effective notification strategies for infection control and prevention.
Leal et al. (Sun,) studied this question.