Abstract
In order to identify the status of vancomycin resistant enterococi (VRE) carrier in our hospital, periodical rectal swab cultures were obtained from the patients hospitalized in the Pediatrics Unit, Neurosurgery Intensive Care Unit and Reanimation Unit. VRE strains isolated were examined for type identification, antibiotic sensitivity, High Level Gentamicin Resistance (HLGR), High Level Streptomycin Resistance (HLSR), beta-lactamase production and genotypic resistance patterns. Rectal swab cultures were obtained from 250 patients and 38 of these (15%) were VRE positive. 28 (73.6%) of the enterococci were Enterococcus faecium, 6 (15.8%) were Enterococcus casseliflavus, 3 (7.9%) were Enterococcus gallinarum and 1 (2.7%) was Enterococcus faecalis. 24 strains were identified to have Van A resistance pattern. None of the strains have beta-lactamase. HLGR was identified at a rate of 92% and HLSR at a rate of 95%. In addition to glycopeptide resistance, VRE strains had high levels of Ampicillin, Penicillin, Erythromycin, Rifampicin, Chloramphenicol and Nitrofurantoin resistance. Quinolon resistance was found to be at moderate level (34%, 45%), while Tetracycline (29%), Fosfomycine (6%), Dalfopristin-quinupristin (3%) and Linezolid (0%) were found to be the most effective antimicrobials. Key words: Enterococcus, rectal colonization, vancomycin resistance.
Highlights
Vancomycin resistance in Enterococci was first described in 1988 and resistant strains became widespread worldwide (Uttley et al, 1998)
In order to identify the status of vancomycin resistant enterococi (VRE) carrier in our hospital, periodical rectal swab cultures were obtained from the patients hospitalized in the Pediatrics Unit, Neurosurgery Intensive Care Unit and Reanimation Unit
Rectal swab cultures were obtained from 250 patients and 38 of these (15%) were VRE positive. 28 (73.6%) of the enterococci were Enterococcus faecium, 6 (15.8%) were Enterococcus casseliflavus, 3 (7.9%) were Enterococcus gallinarum and 1 (2.7%) was Enterococcus faecalis. 24 strains were identified to have Van A resistance pattern
Summary
Vancomycin resistance in Enterococci was first described in 1988 and resistant strains became widespread worldwide (Uttley et al, 1998). Asymptomatic VRE colonization can lead to infections. VRE infections are important causes of mortality and morbidity and their treatment is expensive (Milestone et al, 2010). Identification of VRE colonization is important for the control of VRE infections. The most important VRE reservoirs are those patients who carry VRE in their gastrointestinal systems (Robert et al, 2005). If surveillance cultures are not performed on patients having high risk, asymptomatic carriership can be missed. Standard culture methods and molecular techniques like PCR are important for the identification of VRE colonization and prevention of outbreaks
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