Abstract
Infection with vancomycin-resistant enterococci (VRE) is reported to be increasing and becoming a problem especially in health care systems with prolonged survival in the environment. In this study, we compared the performance characteristics of CHROMagar with conventional methods for detection of VRE in clinical urine specimens. A total of 7404 urine samples were entered in the study. All specimens were cultured by routine microbiological method and were simultaneously cultured in prepared CHROMagar plate for growth characteristics with positive and negative controls. Susceptibility tests were performed by disk diffusion method as recommended by Clinical Laboratory Standards Institute. We also used E-test minimum inhibitory concentration (MIC) for confirmation of VRE isolates. Total isolation rate was 22.19% of the tested specimens. Enterococcus faecium andEnterococcus faecalis were isolated in 10 (0.13%) and 72 (0.92%) cases, respectively while six were VRE belonging to admitted patients. Analyzed data of VRE cases revealed the results of all three applied methods. The antimicrobial susceptibility testing, E-test and CHROMagar were in agreement in all the six identified VRE cases. The obtained results in the present study indicate that CHROMagar method is easy to use, and is a cost- and time-effective procedure for the isolation of VRE especially in urine specimens. Key words: Vancomycin-resistant enterococci (VRE), CHROMagar, admitted patients.
Highlights
Enterococci are normal flora of the intestinal tract in humans and animal
The obtained results in the present study indicate that CHROMagar method is easy to use, and is a cost- and time-effective procedure for the isolation of vancomycin-resistant enterococci (VRE) especially in urine specimens
There are more than one dozen species of Enterococci; Enterococcus faecalis and Enterococcus faecium are the most important pathogens and account for approximately 85 to 90% and 5 to 10% of human infections respectively (Gin et al, 1996).Enterococcus species has been recognized as an important cause of hospital acquired infections in the mid 1970s
Summary
Enterococci are normal flora of the intestinal tract in humans and animal. This organism may colonize in other anatomical sites of the body such as reparatory tract, vagina and biliary tract in healthy persons (Zhanel et al, 2003; Deshpande et al, 2007). In a recent report of Centers for Disease Control (CDC), Enterococcus species was isolated from 12% nosocomial infection, and was the third most common pathogen isolated (NNIS, 2004; Furtado et al, 2006). Urinary tract infections (UTI) are the most common nosocomial infection caused by Enterococci in adults (Sonavan et al, 2008; Behroozi et al, 2010). Infections caused by VRE in Iran, like other countries, is associated with a high rate of mortality and morbidity.
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