The prevalence of fecal carriage of antibiotic resistant enterococci among hospitalized patients in Shahid beheshti hospital, Kashan, Iran at 2007

The aims of this study were to determine the prevalence of antibiotic resistant enterococci colonization in the intestinal tract of hospitalized patients and define the risk factors. This descriptive study was carried out on a group of patients (No=198) hospitalized for at least 48h at a teaching hospital. Resistance to vancomycin was detected by the E-test method. Antibiotic susceptibility tests were performed using Kirby-Bauer disk diffusion method. Epidemiological data recorded for all patients were used for risk factor analysis. A total number of 198 hospitalized patients were enrolled in this study. One-hundred out of 198 patients (50.5%) were colonized with enterococci spp. E-test revealed that 27% of patients were colonized with vancomycin-resistant enterococci (the minimum inhibitory concentration (MIC) more than 32 mg/ml). The disk diffusion test showed that 96 out of 100 strains were resistant to streptomycin, 82% to erythromycin, 70% to ciprofloxacin, 60% to nitrofurantoin and ampicillin, 44% to gentamicin, 38% to tetracycline, 34% to penicillin-G vancomycin, 33% to linezolid and 20% to levofloxacin. Isolation of vancomycin-resistant enterococcus (VRE) was not significantly associated with age, sex, use of total parenteral nutrition (TPN), use of central venous catheter, long-term hospitalization period and antibiotic usage. However, it was significantly associated with the underlying disease (P=0.008). Urgent infection control measures are required to prevent the emergence of VRE outbreaks in hospital settings. Moreover, since the occurrence of VRE is increasing, the optimization of laboratory facilities to detect vancomycin resistant strains seems vital.