Prevalence and risk factors associated with vancomycinresistant enterococci colonization

Abstract

Enterococci have been recognized as clinically important pathogen in high-risk population of hospitalized patients. The aims of this study were to detect the prevalence of intestinal vancomycin-resistant enterococci (VRE) colonization among patients in the high-risk departments and the risk factors related to resistance in hospitalized patients in where VRE had been rarely isolated previously in Tepecik Educational and Research Hospital, Izmir, Turkey. Following the first isolation of VRE in two patient in intensive care unit (ICU) and neonatal ICU in the same day, we carried out a point prevalence culture survey. Rectal swabs were obtained from patients. For comparison, 30 control patients hospitalized in internal medicine service were also analyzed. Ninety-three patients were investigated. Eighteen patients (19.3%) were found to be VRE carriers, whereas none of the control group patients had VRE. Thirteen strains were identified as Enterococcus faecium, four were Enterococcus gallinorum, and one was Enterococcus casseliflavus. Nine of E. faecium strains were resistant to vancomycin; the remainders were intermediate resistance to vancomycin and all of them sensitive to teicoplanin. Lengths of hospital stay, age and low birth weight for newborn were significantly associated with VRE colonization. A high prevalence of colonization by VRE was found at our ICUs, emphazing the importance of length stay in the ICU and low birth weight for newborn as a risk factor for colonization. VRE colonization must be monitored and risk factors should be determined, because of establish prevention and control measures.