Distribution of vancomycin resistant enterococci and their resistance patterns determined by surveillance

In order to identify the status of vancomycin resistant enterococi (VRE) carrier in our hospital, periodical rectal swab cultures were obtained from the patients hospitalized in the Pediatrics Unit, Neurosurgery Intensive Care Unit and Reanimation Unit. VRE strains isolated were examined for type identification, antibiotic sensitivity, High Level Gentamicin Resistance (HLGR), High Level Streptomycin Resistance (HLSR), beta-lactamase production and genotypic resistance patterns. Rectal swab cultures were obtained from 250 patients and 38 of these (15%) were VRE positive. 28 (73.6%) of the enterococci were Enterococcus faecium, 6 (15.8%) were Enterococcus casseliflavus, 3 (7.9%) were Enterococcus gallinarum and 1 (2.7%) was Enterococcus faecalis. 24 strains were identified to have Van A resistance pattern. None of the strains have beta-lactamase. HLGR was identified at a rate of 92% and HLSR at a rate of 95%. In addition to glycopeptide resistance, VRE strains had high levels of Ampicillin, Penicillin, Erythromycin, Rifampicin, Chloramphenicol and Nitrofurantoin resistance. Quinolon resistance was found to be at moderate level (34%, 45%), while Tetracycline (29%), Fosfomycine (6%), Dalfopristinquinupristin (3%) and Linezolid (0%) were found to be the most effective antimicrobials.