Prevalence of Vancomycin-Resistant Enterococci and antibiotic resistance pattern in patients referred to Ganjavian hospital, Dezful

BACKGROUND AND OBJECTIVESNowadays, the resistance of bacteria to antibiotics has affected the success of treatment of infectious diseases all over the world. In recent decades, the role of enterococci as one of the causative factors of hospital infections in urinary infections, wounds and fatal bacteremia has become very important. Severe complications of bacteremia and enterococcal endocarditis are associated with high mortality.MATERIALS AND METHODSIn this cross-sectional study (July ۲۰۲۲ to July ۲۰۲۳), clinical samples of blood, urine, wounds and body fluids of outpatients and inpatients at Ganjavian hospital were collected and cultured on Blood and MacConkey agar. The phenotypic identification of the isolates was done by gram staining and biochemical tests of catalase, arabinose fermentation and bile esculin hydrolysis, and antibiotic sensitivity testing was done by disc diffusion method based on CLSI. The resistance of enterococcus strains to vancomycin was determined by the vancomycin agar method. Genotypic identification of isolates was done by PCR method of ddl and vanA genes.RESULTS AND DISCUSSIONIn the present study, ۱۲۰ enterococcus including Enterococcus faecium and E. faecalis were collected with frequency of ۶۰.۷% and ۳۹.۳%, respectively, which were collected from patients of internal departments with ۳۱.۴%, ICU with ۲۰.۹%, and then outpatients. Most of the samples included urine culture ۷۶.۶%, wound culture ۱۰.۴% and blood culture ۷.۸%. In vancomycin agar method (۳۲.۵%) ۳۹ resistant isolates were identified, of which ۸۹.۷% were Enterococcus faecium. vanA gene was detected in ۲۱ isolates. The antibiotic resistance of VRE isolates to penicillin, ampicillin, ciprofloxacin, and tetracycline was observed as ۸۷.۲, ۸۷.۲, ۹۴.۹, and ۷۶.۹%, respectively, and nitrofurantoin was the most effective antibiotic in urinary infections.CONCLUSIONThe resistance of one third of enterococci to vancomycin, which is one of the most widely used antibiotics in the treatment of gram-positive infections, is a serious concern in the treatment of infectious patients, which requires more monitoring by infection control committees and the establishment of the antimicrobial stewardship program and has access to newer and more effective antibiotics.