Title : Colonization and infection in admitted patients with vancomycin-resistant enterococcus in a tertiary hospital
Abstract:
Enterococci are gram-positive, facultative anareobic bacteria that are usually found in gastrointestinal tract of humans, animals and environmental sources. Enterococci can lead to severe hospital-acquired infections and are difficult to treat due to their high level of antibiotic resistance. Vancomycin-Resistant Enterococci (VRE), are strains that developed resistance to vancomycin which is used against gram-positive bacterial infections. VRE are one of the most common nosocomial pathogens that cause colonisation and infection both in hospitalized patients.
We aim to better understand whether the patient is only carrier or infected with VRE by conducting a retrospective study including admitted patients between 2019 and 2024 at Selcuk University Hospital.
1467 rectal swab samples were inoculated onto chromogenic VRE agar and incubated at 37°C. After bacterial growth, identification was performed using the Vitek-2 automated system. The disc diffusion method was used to determine antibiotic susceptibility according to EUCAST guidelines.
Out of 157 rectal swab culture-positive patients, 97 patients (61.7%) were only colonized and 60 patients (38.2%) were infected by VRE. 30 patients (19.1%) had cystitis, 18 patients (11.4%) had blood-stream infection, three patients (1.8%) had meningitidis yet one of them was shunt-associated, two patients (1.2%) had catheter infection, two patients (1.2%) had wound infection, one patient (0.6%) had both cystitis and blood-stream infection, one patient (0.6%) had both cystitis and peritonitis, one patient (0.6%) had both cystitis and catheter infection; one patient (0.6%) had both blood-stream infection and pleuritis, one patient (0.6%) had tissue infection.
In conclusion, we observed a high rate of infection in VRE carriers. The highest percentage of patients had cystitis however life-threatning infections such as blood-stream and meningitis are also observed. Since VRE easily spread among admitted patients, comply with the rules of isolation plays a key role in protecting non-colonized patients. Determining the source is crucial for preventing transmission of VRE by especially the hands of medical staff or devices within the hospital.
