Prevalence and genotypic identification of Vancomycin-resistant Enterococci in patients in a hospital environment.
DOI:
https://doi.org/10.51481/amc.v46i1.130Keywords:
enterococos, enterococos vancomicinaresistentes, vancomicina, resistencia a antibióticos, antibióticosAbstract
Justification and Objectives: Enterococcus are Gram positive bacteria involved in community and nosocomial infections. There has been an increased interest in these bacteria because of their resistance to multiple antimicrobial drugs and their transposonmediated resistance to glycopeptides.
Patients and methods: this is a prospective, and experimental study conducted from may to august 2001. We studied 106 patients hospitalized in the Intensive Care Units (ICU) of the Hospital México and Hospital San Juan de Dios and also the Medical Emergency Ward of the latter. Rectal swaps were taken in order to isolate VRE and to study the minimal inhibitory concentrations of vancomycin. Strains isolates with higher MIC's were studied for genetic determinants
Results: VRE colonization rates in gastrointestinal tract were 52%. Using the chi square test and logistic regression some factors were identified for gastrointestinal tract colonization, being service of origin before admission to ICU, days of stay in ICU and previous use of third generation cephalosporins the main ones. VRE with MIC ≥512 mg/ml were demonstraded in 29.6% of the isolates, and in all of them (E.gallinarum, E.,faecium, E. casseliflavus, and E.hirae) the van A gen was found. All E. faecalis isolates showed vancomycin MIC£16 mg/ml.
Conclusions: We found a high colonization rate of the gastrointestinal tract, higher than the reported prevalence in other studies in the medical literature. Few studies in world wide literature have identified the van A gene in nonpathogenic enterococci. The relevance of these findings is discussed.
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