Enterococci in hospital associated infection in the national liver institute, Egypt

ABSTRACT

Enterococci have become important opportunistic pathogens in hospitalized patient's especially vancomycin resistant strains. This study was done to assess the prevalence of enterococci infection including vancomycin resistant enterococci [VRE] among patients admitted of National Liver Institute, to detect the possible risk factors involved in enterococci infection and to analyze the relationship between antimicrobial susceptibility pattern and plasmid profile. After identification of the isolated organisms, they tested the antibiotic susceptibility using the disc diffusion methods determine the MIC and E-test-strips, and plasmid profile analysis by agarose gel electrophoresis. The prevalence of enterococci was 20.5% , most of them were resistant to cefotaxime, ceftazidime and, cephalexin [93%], amikacin [88.4%], and vancomycin [20.91] by disc diffusion, but vancomycin resistant by E test was [23.3%] with 93.2% agreement between both methods. Six different resistance patterns [with minor 32 patterns] were found among enterococci isolates. Plasmid profile analysis showed that [44.2%] were plasmid less, while 55.8% contained plasmids with variable molecular weight ranging from 1.5 MDa to 42 MDa. Moreover, resistance to increasing numbers of antibiotics was associated with high molecular weight plasmids. In conclusion multi-resistant enterococci are important cause of Hospital associated infections. Most of these strains had plasmids, which may be responsible for resistance to antibiotics and its dissemination among the other strains