Identification and characterization of resistance and pathogenicity of Enterococcus spp. in samples of donor breast milk

Table 1 Descriptive analysis of the socioeconomic aspects and hygienic-sanitary conditions related to the collection of human milk and to human milk donors (n = 30) registered in the Human Milk Bank of the Municipal Hospital Esaú Matos in Vitória da Conquista, Bahia State, Brazil

Descriptive analysis of socioeconomic aspects of HM donors
Variable	n	(%)
Age group
Age less than 30 yr	19	63.3
Over 30 yr of age	11	36.7
Marital status/Conjugal state
Married/living with spouse	20	66.7
Single or divorced/without a partner	10	33.3
Family income
Less than 2 minimum wages1	9	30.0
Above 2 minimum wages	21	70.0
Number of children
One child	16	53.3
Two or more children	14	36.7
Schooling
High school	21	70.0
Graduate	9	30.0
Total	30	100.0
Descriptive analysis of hygienic-sanitary conditions of HM donors
Variable	n	(%)
Hand washing prior to collection
Sometimes/never	1	3.3
Always	29	96.7
Nail size check/trim before collection
Sometimes/never	18	60.0
Always	12	40.0
Hair holding habit before collection
Sometimes/never	6	20.0
Always	24	80.0
Breast lavage before collection
Sometimes/never	4	13.3
Always	26	86.7
Use of mask during collection
Sometimes/never	4	13.3
Always	26	86.7
Avoid talking during collection
Sometimes/never	12	40.0
Always	18	60.0
Discard first jet of milk at the beginning of collection
Sometimes/never	14	46.7
Always	16	53.3
Milk collection
Manual/electric pump	24	80.0
Manual milking	6	20.0
Cleaning frequency of the pump2
Sometimes/never	0	0
Always before using	241	100.01
Total	30	100.0

¹Minimum wage in the period: BRL954,00. ²Question applied only to donors who reported performing milking by hand and using an electric pump.

Table 2 Sensitivity profile of the isolates (n = 11) of Enterococcus spp. found in relation to the list of antimicrobials evaluated following the recommendations of the Clinical and Laboratory Standards Institute (2017)

Antimicrobials	Sensitive, n (%)	Intermediate, n (%)	Resistant, n (%)
Ampicillin 10 µg	11 (100.0)	0 (0)	0 (0)
Penicillin 10 un	9 (81.8)	0 (0)	2 (18.2)
Tetracycline 30 µg	4 (36.4)	0 (0)	7 (63.6)
Ciprofloxacin 5 µg	7 (63.6)	3 (27.3)	1 (9.1)
Norfloxacin 10 µg	9 (81.8)	0 (0%)	2 (18.2)
Levofloxacin 5 µg	10 (90.9)	0 (0)	1 (9.1)
Nitrofurantoin 300 µg	9 (81.8)	0 (0)	2 (18.2)
Linezolid 30 µg	11 (100.0)	0 (0)	0 (0)
Vancomycin 30 µg	11 (100.0)	0 (0)	0 (0)

un: Units.

Table 3 Distribution of the virulence genes of Enterococcus faecium, Enterococcus faecalis, and Enterococcus spp.

Virulence genes	E. faecalis		E. faecium		Enterococcus spp.		Total
	N (isolated )	%	N (isolated )	%	N (isolated )	%	N (isolated )	%
Ace	1a	33	1a	33	2	67	3	27
efaA	3b	43	2b	28	3	43	7	63
gelE	0	-	0	-	0	-	0	-
As	0	-	0	-	0	-	0	-
cylA	0	-	0	-	0	-	0	-
Hyl	0	-	0	-	0	-	0	-
Esp	0	-	0	-	0	-	0	-

^aace gene found in 1 isolate (containing strains of Enterococcus faecalis and Enterococcus faecium). ^befaA gene found in three Enterococcus faecalis isolates (being a single isolate of Enterococcus faecalis and two isolates of Enterococcus faecalis and Enterococcus faecium). E. faecalis: Enterococcus faecalis; E. faecium: Enterococcus faecium.