PREVALENCE OF VANCOMYCIN RESISTANT ENTEROCOCCI AMONG PATIENTS WITH NOSOCOMIAL INFECTIONS IN INTENSIVE CARE UNIT

Abstract

Background: Enterococcus has increasingly become a major nosocomial pathogen worldwide. It has been well documented that intensive care units (ICUs) are the major reservoirs of vancomycin resistant enterococci (VRE) in the health care setting. It is a matter of concern due to its ability to transfer vancomycin resistant gene to other organisms. Objective: Evaluation of the incidence of VRE as a cause of nosocomial infection in ICU patients, to analyze their antibiotic resistance profile, and to search for resistance genes of VanA and VanB in VRE isolates from these patients. Patients and methods: Four hundred ICU patients with nosocomial infections were studied during the period between Jan, 2016 and Feb, 2017 at Misr University for Science and Technology Hospital. Results: Enterococci were isolated from 12% of patients, of whom 66.7% E.faecalis and 33.3% E. facium. 41.7% isolates exhibited resistance to vancomycin. Among these isolates, 60% of strains were E. faecium, while 40% were E. faecalis. Polymerase chain reaction (PCR) detection of Van A and Van B resistance genes showed that Van A gene was detected in 85% of the VRE isolates, while Van B gene not found in any of the VRE isolates. Conclusion: VRE and Van A gene were important as a cause of nosocomial infections in ICU patients. All VRE were multidrug resistant and few treatment options were available. Effective infection control measures against VRE are required.