Prevalence of vancomycin resistance phenotypes among Enterococcus species isolated from clinical samples in a Romanian hospital

Vancomycin resistant Enterococcus (VRE) has been increasingly reported since the 1980s. Although normally regarded as harmless commensals, enterococci can become the etiological agents of nosocomial infections causing urinary tract infections, peritonitis,bacteriemia, wound infections and endocarditis. The acquisition of vancomycin resistance has seriously affected the treatment and infection control of these bacteria. VRE are frequently resistant to most antibiotics that are effective against vancomycin susceptible enterococci, the therapeutic options of VRE infections being thus very limited. The aim of this study was to assess the genetic support of vancomycin resistance among VRE strains isolated from patients admitted to intensive care units in one hospital unit from Bucharest,Romania Out of 84 enterococcal strains isolated from urine prelevated from catheterized and non-catheterized patients with urinary tract infections, wound secretions, pus, blood, ascite liquid and stool, 28 strains had glycopeptide resistance. Out of these, in the 12 vancomycin-resistant Enterococcus faecalis strains, the VanA phenotype was detected in 9 strains and VanB in 3 strains. From the 16 E.faecium strains resistant to vancomycin, 10 strains showed the VanA phenotype and 6 strains had the VanB phenotype. According to the results of this study, the VanA phenotype, conferring high-level resistance to vancomycin and teicoplanin, was more prevalent than VanB in the Enterococcus sp. strains isolated from hospitalized patients.