First detection of vanB phenotype-vanA genotype vancomycin-resistant enterococci in Egypt

Abstract

Introduction: Enterococci have emerged in last two decades as serious hospital acquired pathogens particularly vancomycin resistant strains (VRE). The study aimed to identify the prevalence of enterococcal isolation from hospital infections and colonization as well as determine vancomycin resistance phenotypes and genotypes. Methods: Sixty enterococcus isolates were isolated from patients, health care workers and hospital environment, identified and tested for antimicrobial susceptibility. Enterococcus species were identified by Real-time PCR and vancomycin resistance was assessed by agar dilution method and Real-time PCR. Results; out of 300 samples (20%) were enterococci (53.3% were E. faecium, 31.7% E. faecalis and 10% other enterococci). Among of them 40/60 (66, 6%) were isolated from infections and 33.3% were isolated from colonization. multiple drug resistance was reported in (100%) of isolates, while (95%) and (45%) of isolates were resistant to vancomycin and ticoplanin respectively. VanA phenotype, vanA genotype was identified in (47.4%) of isolates, while vanB phenotype, vanA genotype was identified in (33.3%) of vancomycin resistant isolates. Conclusion; VanB phenotype-vanA genotype was identified in (33.3%) of vancomycin resistant enterococcal isolates. To our knowledge it is the first identified incidence of such strains in Egypt and Africa.