الفهرس 
Introdution And Aim Of The WorkOnly 14 pages are availabe for public view
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Abstract
Summary
Enterococci are Gram-positive cocci and are normal intestinal inhabitants of the human .
They have also become important nosocomial pathogens due to their intrinsic antimicrobial resistance and their capacity to acquire antimicrobial resistance. Within the genus Enterococcus, 47 species were known Enterococcus faecium, and Enterococcus faecalis are clinically the most important.
Several virulence factors have been described in enterococci
including cytolysins, gelatinase, hyaluronidase,aggregation substance, extracellular surface protein, cell wall adhesins and biofilm formation .
Biofilms are complex microbial cell surface polysaccharide matrix that binds irreversibly causing bacteria survive in unfavorable conditions .
Glycopeptide resistance in enterococci is encoded by van genes. VanA and vanB genes are the two most significant ones. VanA confers high-level inducible resistance to both vancomycin and teicoplanin.
This study was carried out at Beni- Sueif University Hospital over a period of one year from June 2015 to June 2016 as a Prospective surveillance
To determine :
1.Incidence of enterococcal infections and VRE in adult immunocompromised patients.
2. Incidence of Van A and Asa1 genes among these patients .
During the study period, a total of 80 different samples were collected,40 of them were enterococci . Their ages ranged from 20 to 90 years.
Each patient was subjected to proper history taking and the proper sample was taken and sent to our microbiology laboratory .
Enterococcal isolates were subjected to PCR to detect VanA and asa1 genes.
In our study 20% of isolates were VRE . VanA and asa1 gene was detected in 30% and 57.5% respectively. Most of enterococcal isolates were collected from urine culture(60%) and from ICU patients(45%). All isolates were resistant to amoxicillin- clavullinic. No stastically significant difference between VRE and VSE as regards presence of risk factors(DM , department , antibiotic usage and underlying diseases).
Finally we recommended to avoid imprical use of antibiotics and to implement appropriate infection control measures to limit nosocomial spread of VRE.