Investigation of the Epidemiology and Antibiotic Resistance of Vancomycin-Resistant Enterococcus (VRE) Strains Isolated from Clinical Samples in Algeria

Abstract

The vancomycin resistance continues to spread in Enterococcal infections throughout the world. In Algeria, these infections caused by of Vancomycin Resistant Enterococci (VRE) keep gaining ground, causing exponential morbidity and mortality every day. The greatest threat these bacteria represent is their ability to developed multi-resistance to virtually all antimicrobials currently used and they can cause serious invasive diseases. Our Aim is study and to investigate the isolation, frequency and the level of antibiotic resistance of Vancomycin Resistant Enterococci (VRE).The present study was a prospective study in which Enterococcus was isolated from five different departments. Enterococcal species were identified and confirmed by using VITEK® 2 systems. Antibiotic sensitivity was done by the agar diffusion and Minimum Inhibitory Concentration (MIC) method. SPSS software version 23 (IBM Statistical Package for the Social Sciences (SPSS) statistics 23) was used to analyze the data obtained from the study. A total of 135 Enterococcus strains were isolated during the study period, in which we revealed two predominant species E. faecalis 60% (81/135) and E. faecium (54/135). All isolates had a multidrug resistance, thirty seven of VRE isolates including E. faecium (23/37) and E. faecalis (14/37) were distinguished by their resistance to vancomycin  (MICs 32-256 µg/ml) and teicoplanin (MICs 16-256 µg/ml). The most enterococcal strains were isolated from the Internal medicine (47.4%) followed by the intensive care unit ICU (31.9%). These bacterial isolates were obtained mainly from urine (45.9%), and were observed in female patients (62%). The age group between 25 and 45 was the most affected.This work revealed alarming levels of antibiotic resistance in Enterococci, and their ability to transfer resistance genes to highly pathogenic bacteria such as Methicillin resistant Staphylococcus aureus. We should controlling measures to reduce the transmission of these multidrug-resistant organisms.