title: Prevalence and antimicrobial resistance pattern of multidrug-resistant enterococci isolated from clinical specimens.
abstract: OBJECTIVE
  Vancomycin-resistant enterococci (VRE) pose an emerging problem in hospitals worldwide. The present study was undertaken to determine the occurrence, species prevalence, antibacterial resistance, and phenotypic and genetic characteristics of VRE isolated in Riyadh hospitals, KSA.
  
  
  METHODS
  Two hundred and six isolates of enterococcal species were obtained from clinical samples. The antibiotic susceptibility of isolates and minimum inhibitory concentration (MIC) tests for vancomycin and teicoplanin were determined. Molecular typing of VRE isolates was carried out by using pulsed field gel electrophoresis (PFGE) and the resistance genotype was determined by polymerase chain reaction (PCR).
  
  
  RESULTS
  VRE accounted for 3.9% of the isolates and were detected mostly in urine, wound and blood specimens isolated from ICU, internal medicine and surgical wards. All strains were identified to species level and were found to consist of E. faecalis (69.2%), E. faecium (11.3%), E. avium (2.1%), E. hirae (0.8%), E. casseliflavus (1.3%) and E. gallinarum (1.3%) species. According to the susceptibility data obtained, 8 (3.9%) out of 206 isolates were found to be VRE (MICs > 32 μg/ml). The vanA, vanB and vanC gene fragments of E. faecalis, E. faecium and E. gallinarum were amplified from isolates and were detected. PFGE patterns of the VRE isolates revealed homogenous patterns with dominant clone suggesting that the strains intrinsic resistance is independent.
  
  
  CONCLUSIONS
  This study shows an emergence of VRE along with increased rate of multidrug-resistant enterococci in the area of the study. Regular surveillance of antimicrobial susceptibilities should be done regularly and the risk factors should be determined.
authors.affiliation: Department of Pharmaceutics, Kayyali Chair for Pharmaceutical Industries, College of Pharmacy, King Saud University, P O Box 2457, Saudi Arabia. mounirmsalem@yahoo.com
authors.forename: M M
authors.initials: MM
authors.lastname: Salem-Bekhit
authors.forename: I M I
authors.initials: IM
authors.lastname: Moussa
authors.forename: M M
authors.initials: MM
authors.lastname: Muharram
authors.forename: F K
authors.initials: FK
authors.lastname: Alanazy
authors.forename: H M
authors.initials: HM
authors.lastname: Hefni
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D024901:Drug Resistance, Multiple, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D016983:Enterococcus / Q000145:classification* / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology*; D006801:Humans; D008826:Microbial Sensitivity Tests; D058889:Molecular Typing; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012529:Saudi Arabia / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents