Prevalence of Vancomycin Resistant Enterococci in Hilla City, Iraq


Objectives: To identify the prevalence of enterococci species in hospitalized patients with urinary tract infection in Hilla City, to determine their susceptibilities to vancomycin and other antibiotics.Materials and methods: Two hundred urine samples were obtained from patients who were admitted to three main hospitals in Hilla city during a period of three months (from November 2010 to February 2011). After identification of enterococcal species by biochemical tests, the antibiotic susceptibility of isolates was determined by standard disk diffusion test according to CLSI. MIC tests for vancomycin and teicoplanin were also carried out for VRE isolates by methods of agar-dilution and HiComb test.Results: This study revealed that out of 200 samples, Enterococcous species was isolated only from 7 samples, which were identified to genus level. 5/7 isolates were catheter-related infection. According to susceptibility data obtained, Five isolates were resistant to vancomycin (71.43%) with an MIC ranging from 8-32 μg/ml but they were sensitive to teicoplanin (MIC < 0.25 μg/ml), thus exhibited VanB phenotype, and the majority of isolates (86%) showed multi-drug resistance pattern. All isolates were highly resistant (85.72%) for each of chloramphenicol, rifampicin and erythromycin. On the other hand, 71.43% of isolates were resistant to each of penicillin and tetracycline while they were moderately resistant to ampicillin (57.14%) and ciprofloxacin (42.86%), in comparison to relatively low resistance to nitrofurantoin 14.29%.Conclusion: Finding of this study shows an emergence of VRE along with increased rate of multi-drug resistant enterococci in the area of the study.