ABSTRACT

Objective:

In recent years, vancomycin-resistant enterococcus (VRE) infections are among the common nosocomial infection factors, especially in intensive care units (ICU). In our study, it was aimed to evaluate the resistance rates of enterococci, which are isolated as a hospital infection (HI).

Materials and Methods:

The source and resistance rates of HIs due to enterococci were investigated retrospectively in patients hospitalized in Konya Training and Research Hospital in five years. ICU follow-up forms, National Hospital Infections Surveillance data were taken into consideration in determining these patients. HIs; “Centers for Disease Control and Prevention” was defined according to diagnostic criteria, all samples were evaluated by conventional culture methods.

Results:

6.24% (177) of the factors in all nosocomial infections (2,835) recorded in our hospital were linked to enterococcal spp. 54.8% (97) of the infections were in ICU and 45.2% (80) were in the services. 57.63% (102) of enterococci reproduced in the urine, 27.11% (48) in the blood, 13.56% (24) in the swab cultures of the wound. VRE was the cause of 7 of the patients who were accepted nosocomial infections due to enterococci. The VRE rate is 0.24% among all (2,835) nosocomial infections and among nosocomial infections due to enterococci; It was found to be 3.4%. All VREs were detected as Enterococcus feacium (100%). The most common risk factors in patients were advanced age, urinary and central venous catheters, acute kidney injury or chronic kidney failure. The use of glycopeptides before VRE infection was 42.85%, and 100% of patients had previously used 3^rd generation cephalosporins.

Conclusion:

The more important the isolation, correct identification and determination of antibiotic susceptibility in the infections caused by enterococci, the more vital it is to monitor the antibiotic susceptibility profiles for these bacteria.

Keywords: Resistance, hospital infection, VRE

References

Topçu AW, Söyletir G, Doğanay M. Enfeksiyon Hastalıkları ve Mikrobiyolojisi. 2. Cilt. 2017. p. 1797-803.

Bulut A, Şengül H, Kaşıkçı ÖH. Vancomycin Resistant Enterococcus Surveillance Study: A State Hospital Example. JAREN 2018;4:21-7.

Woodford N, Johnson AP, Morrison D, Speller DC. Current perspectives on glycopeptide resistance. Clin Microbiol Rev 1995;8:585-615.

Aktaş G, Derbentli Ş. The Importance and Epidemiological Characteristics of Vancomycin-Resistant Enterococci. İnfeksiyon Dergisi (Turkish Journal of Infection) 2009;23:201-9.

Sümerkan B. Vankomisine dirençli enterokoklar. In: Günaydın M, Esen Ş, Saniç A, Leblebicioğlu H, eds. Editors. Sterilizasyon Dezenfeksiyon ve Hastane İnfeksiyonları Samsun:Samsun İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Araştırmaları Derneği 2002. p. 329-34.

Chenoweth C, Schaberg D. The epidemiology of enterococci. Eur J Clin Microbiol Infect Dis 1990;9:80-9.

Karahocagil MK, Yaman G, Göktaş U, Sünnetçioğlu M, Çıkman A, Bilici A, et al. Hastane Enfeksiyon Etkenlerinin ve Direnç Profillerinin Belirlenmesi. Van Tıp Dergisi 2011:18:27-32.

Aykut Arca E, Dinç BM, Karabiber N. Distribution to Clinics of Enterococci Species Isolated from Various Clinical Samples. Türk Hij Den Biyol Derg 2009;66:1-5.

Mert Dinç B, Aykut Arca E, Yağcı S, Karabiber N. In-vitro Antibotic Susceptibility of Enterococcus faecalis and Enterococcus faecium Strains Isolated from Various Clinical Samples Türk Hij Den Biyol Derg 2009;66:117-21.

Aral M, Ece Paköz Nİ, Aral İ, Doğan S. Çeşitli klinik örneklerden izole edilen Enterococcus faecalis ve Enterococcus faecium suşlarının antibiyotik direnci. Turk Hij Den Biyol Derg 2011;68:85-92.

Ulusoy S. Yoğun bakım ünitesinde Gram-pozitif mikroorganizmalar ve direnç sorunu. Yoğun Bakım Dergisi 2003;3:118-28.

Gazi H, Kurutepe S, Sürücüoğlu S, Ecemiş T, Özbakkaloğlu B. Antimicrobial Resistance in Nosocomial Enterococcus faecalis and Enterococcus faecium Strains. ANKEM Derg 2004;18:49-52.

Zhanel GG, Adam HJ, Baxter MR, Fuller J, Nichol KA, Denisuik AJ, et al. Antimicrobial susceptibility of 22746 pathogens from Canadian hospitals: results of the CANWARD 2007-11 study. J Antimicrob Chemother 2013;68 Suppl 1:i7-22.

The European Antimicrobial Resistance Surveillance System EARS-Net Results. (2015).Available from: http://www. ecdc. europa. eu/en/ health topics/ antimicrobial_resistance/database/Pages/database.aspx.

Cattoir V, Leclercq R. Twenty-five years of shared life with vancomycin-resistant enterococci: is it time to divorce? J Antimicrob Chemother 2013;68:731-42.

O’Driscoll T, Crank CW. Vancomycin-resistant enterococcal infections: epidemiology, clinical manifestations, and optimal management. Infect Drug Resist 2015;8:217-30.

Aktepe OC, Aşık G, Çiftçi İH, Çetinkaya Z. Antibiotic Resistance Rates in Enterococcus Strains Isolated from Clinical Specimens. Türk Mikrobiyoloji Cem Derg 2011;41:86-90.

Ulusal Hastane Enfeksiyonları Sürveyans Ağı (UHESA) Raporu, Özet veri (2011-2015). http://uhes.saglik.gov.tr/UHESA.

Tünger A, Aydemir S, Uluer S, Cilli F. In vitro activity of linezolid & quinupristin/dalfopristin against Gram-positive cocci. Indian J Med Res 2004;120:546-52.

NNIS System. National Nosocomial Infections Surveillance (NNIS) System Report, Data Summary from January 1990-May 1999, issued June 1999. A report from the NNIS System. Am J Infect Control 1999;27:520-32.

Pfaller MA, Korten V, Jones RN, Doern GV. Multicenter evaluation of the antimicrobial activity for seven broad-spectrum beta-lactams in Turkey using the Etest method. Turkish Antimicrobial Resistance Study Group. Diagn Microbiol Infect Dis 1999;35:65-73.

Atalay S, Ece G, Samlıoğlu P, Maraş G, Köse I, Köse S. Evaluation of vancomycin-resistant Enterococcus cases at a tertiary level hospital in Izmir, Turkey. Mikrobiyol Bul 2012;46:553-9.

Evaluation of Vancomycin Resistant Enterecoccal Infections

ABSTRACT

References