Investigation of vancomycin-resistant enterococci faecal carriage in intensive care units of a Turkish teaching hospital in a two-year period
Abstract number: R2335
Iris N., Sayiner H., Simsek F., Arat M., Yildirmak T.
Objective: Vancomycin resistant enterococi constitute a major problem in nosocomial infections. The purpose of this study is to access the prevalance, resistance patterns, antibiotic susceptibilities of enterococci isolates and investigate the risk factors of carriage among the ICU patients in our hospital.
Methods: During two year period; between April 2005 and April 2007; rectal swab cultures were collected from patients in ICU. Samples were collected from patients in first 72 hours after hospitalisation and then repeated every 7 days until patient's discharge. Samples were cultured in VRE agar bases which contain 6 mg/ml vancomycin and 1 mg/ml meropenem. Identification was performed by conventional methods and Rapid ID 32 Strep (bioMerieux). Vancomycin resistance was detected by E test and Van gene characterisation was performed by a multiplex PCR. Antibiotic susceptibility patterns of strains for fosfomycin and linezolid was detected by disk-diffusion methods according to CLSI criteria.
Results: In two year period 21 VRE were isolated from 112 patients (18.75%). VRE faecal carriage period range was 172 weeks. Association between VRE colonisation and use of antimicrobials was investigated. Faecal carriers were using two or more antibiotics. Mostly used antibiotics were 3rd and 4th generation cefalosporins, vancomycin, levofloxacin and piperacillin-tazobactam. Fosfomycin and linezolid susceptibilities were investigated. All of VRE isolates were susceptible to linezolid and only one strain (4.5%) was resistant to fosfomycin. Van gene characterisation was performed in 10 strains and all of them were Van A type.
Conclusion: VRE colonisation must be monitored and risk factors should be determined in ICU's. Use of broad spectrum antibiotics is an important risk factor for VRE colonisation. Invitro linezolid and fosfomycin are effective on VRE strains.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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