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Vancomycin resistant enterococci as a cause of nosocomial infections at Cairo University Hospital

Thesis

Last updated: 06 Feb 2023

Subjects

-

Tags

Microbiology & Immunology

Advisors

Sedqi, Nagwa A., Gumaa, Basma H., El-Feqi, Muhammad A.

Authors

Madani, Nadya Muhammad

Accessioned

2017-03-30 06:23:40

Available

2017-03-30 06:23:40

type

M.D. Thesis

Abstract

This study was conducted on cases of hospital acquired infections reported to the infection control laboratory in the period from 2001 to 2004. The study included 198 cases of hospital acquired infections; varying between urinary tract infections, bacteremia, wound sepsis, chest infections…etc…Enterococci were isolated from 30 cases, and after testing for antimicrobial susceptibility, 21 cases of vancomycin resistant enterococci (VRE) were identified. These cases included 20 cases of high-level resistance (VanA and VanB phenotypes) and one case of low-level resistance (VanD). Polymerase Chain Reaction was performed on cases of high-level resistance phenotypes to detect the genes responsible for vancomycin resistance. PCR was positive in 14 cases of the 20: 5 were positive for vanA gene, 7 positive for vanB gene while two cases were positive for the two genes together (vanA + vanB). In reviewing the risk factors involved, it was found that some of these cases were subjected to invasive procedure known to breech their natural defenses against infections (e.g, surgical trauma, catheterization, intubation …etc…) while others were subjected to previous antibiotic therapy, by several drugs (one at a time or in different combinations) including vancomycin itself; a fact that was reported to enhance selective pressure for resistant strains.It was concluded from the previous data that avoiding the risk factors, mainly in the form of modulating the regimens of antibiotic therapy, including the avoidance of abuse of antibiotic groups known to stimulate future resistant strains (such as 3rd generation cephalosporins and vancomycin) can help minimize the incidence of resistant hospital acquired infections in general, and VRE infections in particular.

Issued

1 Jan 2005

Details

Type

Thesis

Created At

28 Jan 2023