DETECTION OF VANCOMYCIN RESISTANT ENTEROCOCCI (VRE) ISOLATED FROM URINARY TRACT INFECTIONS (UTI) IN TEHRAN, IRAN

This report describes the frequency of Enteroccoci phenotypic and genotypic susceptibility patterns of VRE (Vancomycin Resistant Enterococci) from three hospitals in Tehran, Iran. One hundred and twenty enterococcal urine cultures were isolate from patients with urinary tract infection (UTI). After identification of enterococcal species by biochemical tests, glycopeptide susceptibility of each isolate was assessed by disk agar diffusion method according to NCCLS guideline. Glycopeptide minimum inhibitory concentration (MIC) for each VRE isolate was determined by the agar dilution method and the vanA gene was detected by PCR. Seven percent (8/120) of the isolates were VRE, including E. faecalis 38% (3/8), E. faecium 25% (2/8), E. mundtii 25% (2/8), and E. raffinosus 12% (1/8). All 8 isolates resistant to vancomycin showed vancomycin MIC of 512μg/ml, and teicoplanin MIC’s ranging from 8- 64μg/ml, and they all possessed the vanA gene. Six (75%) of VRE were isolated from a referral tertiary care hospital, i.e. Ahari Children Medical Center (ACMC). Almost 90% of Enterococci were E. faecalis (57%) and E. faecium (30%). The remaining 13% were identified as E. mundtii (6%), E. avium (3%), E. durans (1%), E. hirea (2%), and E. raffinosus (1%). The diverse VRE species combined with high rate of VRE isolation in Iran, as well as isolation of E. raffinosus and E. mundtii in the Middle East (ME) region for the first time, suggests a rapid spread of resistance among Enterococci along with an emerging shift in VRE distribution in Iran.