الفهرس | Only 14 pages are availabe for public view |
Abstract Vancomycin resistant Enterococci has emerged wide world as a nosocomial pathogen of major importance, and the incidence of infections caused by VRE continues to increase. Since biochemical tests for identification are time-consuming and they are sometimes inconclusive, conventional methods to detect vancomycin resistance as disk diffusion test, E-test and broth microdilution are time-consuming. The automated methods also have some drawbacks; they need expensive equipments and materials and are highly accurate only for E. faecium and E. faecalis; thus, rapid and accurate methods to identify Enterococcus species have been developed. In the present study 50 VRE isolates collected from stools of colonized patients hospitalized in hematology, hepatology departments, intensive care units (ICUs), nephrology and rheumatology departments of Ain Shams University Hospitals, previously known phenotypically by API 20 STREP and E-test were subjected to M-PCR for rapid identification of Enterococcus species and vancomycin resistance genes in the same unique reaction. Regarding Enterococcus species, 40/50 (80%) isolates were confirmed genotypically to be E.faecium. The remaining 10/50 (20%) isolates were E. gallinarum, E.cassiliflavus and E.avium gave negative results by M-PCR because their primers were not included in this study. As regards vancomycin resistant genotype, multiplex PCR confirmed the presence of 25/50 (50%) van A. E.faecium genotype, 8/50 (16%) van B. E.faecium, 9/50 (18%) van C and 2/50 (4%) van D genotype (one of them was vanD E.faecium). Six out of fifty (12%) isolates were susceptible and give negative PCR results for van genes. In the present study, the most prevalent species is E. faecium carrying the most prevalent van A genotype which confers high level resistance to vancoymcin. |