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Isolation and Identification of Waterborne Antibiotic-Resistant Bacteria and Molecular Characterization of their Antibiotic Resistance Genes
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Epidemiology and molecular analysis of intestinal colonization by vancomycin-resistant enterococci in greek hospitals

Achilleas Gikas1, Athanasia Christidou, Efstathia Scoulica

  • 1University Hospital of Heraklion-1352/71110, Crete, Greece. gikas@med.uoc.gr

Journal of Clinical Microbiology
|November 8, 2005
PubMed

Insights

Vancomycin-resistant enterococci (VRE) were found in 20.5% of patients across 13 Greek hospitals. The VanC1 phenotype was most common, but VanA and VanB phenotypes, associated with higher resistance, were also identified.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Clinical Research

Background:

  • Vancomycin-resistant enterococci (VRE) are a significant cause of healthcare-associated infections.
  • Enterococcal infections are increasingly difficult to treat due to rising antimicrobial resistance.
  • Surveillance of VRE phenotypes is crucial for guiding treatment strategies and infection control.

Purpose of the Study:

  • To determine the prevalence and phenotypic characteristics of vancomycin-resistant enterococci (VRE) in Greek hospitals.
  • To identify the distribution of different VRE resistance phenotypes (VanA, VanB, VanC1, VanC2/C3).
  • To analyze the genetic diversity of VRE strains exhibiting VanA or VanB phenotypes using pulsed-field gel electrophoresis (PFGE).

Main Methods:

  • Collection of 1,246 specimens from 13 Greek hospitals.
  • Isolation and identification of 266 vancomycin-resistant enterococci strains from 255 patients.
  • Phenotypic characterization of VRE isolates for vancomycin resistance genes (VanA, VanB, VanC1, VanC2/C3).
  • Pulsed-field gel electrophoresis (PFGE) analysis of 86 isolates with VanA or VanB phenotypes.

Main Results:

  • A prevalence of 20.5% for VRE was observed, with 266 strains isolated from 255 patients.
  • The VanC1 phenotype was the most prevalent (57.1%), followed by VanA (30.8%), VanB (6.4%), and VanC2/C3 (5.6%).
  • The combined prevalence of VanA and VanB phenotypes was 7.5%.
  • PFGE analysis of VanA/VanB strains revealed significant genetic diversity with 46 distinct PFGE groups.

Conclusions:

  • VRE infections represent a considerable burden in Greek hospitals, with the VanC1 phenotype being the most common.
  • The presence of VanA and VanB phenotypes, though less frequent, warrants attention due to their clinical significance.
  • The genetic diversity observed among VanA/VanB VRE strains suggests multiple origins or transmission events, necessitating ongoing surveillance and infection control measures.

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