PREVALENACE OF VANCOMYCIN RESISTANT ENTEROCOCCI IN TERTIARY CARE HOSPITAL, WESTERN, INDIA

Introduction: Vancomycin Resistant Enterococci (VRE) is fast emerging pathogen causes serious & life threatening hospital borne infec-tions. The limitation in therapeutic options has resulted in the development of new drugs such as Quinupristin/ Dalfopristin, Linezolid & Tigecycline.Objectives: This study signals the emergence of VRE in this hospital and also highlights the importance of screening for VRE in isolated enterococci from various clinical samples.Materials and Methods: From July 2010 to July 2011, a total of 250 enterococcal isolates were identified and speciated by standard bio-chemical tests. Antibiotic sensitivity was carried out by disc diffusion test as per CLSI guidelines. Minimum Inhibitory Concentration (MIC) of all the isolates were done by Vancomycin Ezy MICTM Strip ranging from 0.016 μg/ml to 256 μg/ml.Results: Out of the 250 Enterococcus species, 4% (10) isolates were resistant to Vancomycin by disc diffusion & Vancomycin MIC test in which 8 were E. faecium and 2 were E. faecalis. Out of 10 VRE, 7 were resistant and 3 were sensitive to Teicoplanin, so they were of VanA and VanB phenotype respectively. The Vancomycin MIC for seven of these isolates is more than 256 μg/ml. 1.2% showed intermediate resistance and 2.8% high level resistance to vancomycin by MIC according to CLSI guidelines.Conclusion: All laboratories should have effective detection methods for Vancomycin resistance, which will be helpful in treatment of VRE, judiciously with drugs will reduce the morbidity and mortality. VRE surveillance of family members of recently discharged patients VRE-infected, to limit the spread of infection.