Prevalence of vancomycin-resistant enterococci colonisation in gastro-intestinal tract of hospitalised patients in a hospital, Esfahan Province, Iran

Abstract number: P2123

Javadi A., Ataei B., Khoorvash F., Mobasherzadeh S., Tghyani S., Soghrati M.

Introduction: Vancomycin-resistant enterococci (VRE) are the most common nosocomial pathogen worldwide. Colonisation with VRE can lead to serious infection, that some like VRE sepsis can be fatal. Because VRE are dangerous and important pathogens, we are going to determine the prevalence of VRE among patients admitted in infectious, surgery wards and ICU in AL-Zahra Hospital in Isfahan, Iran.

Methods: 100 patients from infectious and surgery (post-operative patients) wards and ICU were selected by simple sampling method. Stool specimens were taken from selected patients and cultured in VRE selective media (bile-esculin agar plate with 6 of vancomycin) and Gram-positive cocci from black colonies were inoculated to the tryptase soya broth+ 6.5% Nacl and again Gram-positive cocci were inoculated to bile esculin and finally MIC (minimal inhibitory concentration) evaluated by E-Test for detection of VRE.

Data were analysed by ANOVA and Chi-square tests using SPSS V13/Win.

Results: 58 out of 100 patients, had positive culture for enterococci. 16 out of 58 were female (27.6%) and 42 (72.4%) were male. Among 58 culture, 17 (29.3%) were highly resistant to vancomycin. There was significant relation between previous antibiotic therapy especially vancomycin and VRE in this study (P = 0.02). Most of the patients (74.1%) with negative culture for enterococci had GI surgery. Most of culture positive patients (46%) had been in infectious ward. No significant relation accompanied between VRE and sex, GI surgery and admission ward in this study.

Conclusion: Results of this study suggest that previous antibiotic therapy especially vancomycin and b-lactam is a major risk factor for colonisation with VRE. Prevalence of VRE was high in our study and this problem is very important in epidemiology of hospital infections. Considering the fact that there is no substitute agent for vancomycin in our country, it is essential to obtain necessary guidelines regarding over treatment with antibiotics specially vancomycin.