PurposeVancomycin-resistant Enterococcus (VRE) faecium (VREfm) are highly resistant bacteria emerging worldwide and rarely studied using molecular tools in Algeria since their first report in 2006. The aim of the study was to investigate healthcare-associated infections (HAIs) involving the first VRE in Batna University Hospital, Algeria, and characterize isolates using molecular tools.Patients and methodsMedical charts were reviewed for patients with VREfm. van genes were detected by multiplex polymerase chain reaction (PCR), and strains were characterized by automated repetitive sequence-based PCR (rep-PCR), multiplex rep-PCR, pulsed-field gel electrophoresis (PFGE), and multilocus sequence typing (MLST).ResultsDuring a 6-month period, VREfm infections occurred in four patients hospitalized in three wards. The four isolates were E. faecium vanA belonging to the hospital-adapted clonal complex 17. PCR-based methods did not discriminate the isolates but MLST and PFGE delineated a subgroup of three VREfm of identical pulsotype and sequence type (ST) 80 (yet identified for five isolates in the international PubMLST database) while the fourth isolate was of ST789 (not previously identified for a VREfm) and displayed an unrelated pulsotype. The three genotypically related isolates were recovered in patients who underwent surgery in the same department, suggesting an outbreak for which the source and route of transmission remained unidentified.ConclusionThis first molecular epidemiology study of VRE in Algeria was useful in delimiting an outbreak involving three of the four HAI cases and revealed rarely encountered genotypes. Considering the threat and burden of VRE infections worldwide, particularly in the USA, and the late emergence in Algeria, our study supports the urgent need for improved and early adequate infection control measures to avoid VRE spread in North African hospitals.
Les Bactéries multi résistantes posent un problème de santé publique, Thérapeutique, de Pronostic et de Prise en charge. Actuellement, la diffusion de carbapénèmases constitue le problème clinique le plus important en matière de résistance aux antibiotiques chez les Gram négatifs, en particulier chez les entérobactéries et le risque de transmission entre patients et élevé. Cette étude a pour objectifs de donner une répartition des BHRe isolées par service et par prélèvements et de sensibiliser aux risques de l'antibiorésistance Il s’agit d’une étude rétrospective avisée descriptive des BHRe isolées des prélèvements pathologiques provenant des différents services du CHU de Batna. Notre enquête a porté sur une année. Tous les prélèvements ont été traités au niveau du laboratoire de bactériologie par un examen microscopique, une culture sur milieux gélosés spécifiques et un antibiogramme selon les normes CLSI. Ces examens ont abouti à un taux de BHRe de 2,20% pour les EPC et 0,5% pour les ERV. Seulement deux espèces sont considérées comme BHRe et qui sont Enterococcus faecium résistants aux glycopeptides quelques soit le mécanisme de résistance (ERV) et Entérobactéries résistantes aux carbapénèmes par production de carbapénèmases (EPC).
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