Enterococcus faecalis and Enterococcus faecium, while being part of human microbiota, are a growing challenge in clinical environments due to their increasing antimicrobial resistance. Specifically, the rise of Vancomycin-resistant enterococci (VRE) is of great concern due to its links to high morbidity and mortality rates in hospitalized patients. This article will examine the prevalence of VRE and explore the associated risks at King Abdulaziz University Hospital from 2015 to 2022.
VRE were detected in collected clinical samples through tools like the VRE Card GeneXpert and BioFire PCR. Patients’ characteristics were analyzed including demographics, comorbidities, hospital exposure and lab findings. The majority of patients with VRE infections were found to have pre-existing conditions such as diabetes, hypertension and kidney disease. This study also observed a peak in VRE infections in 2021, with urine cultures being the primary source. Alarmingly, over 60% of VRE-infected patients within the study tragically succumbed to their illness.
The predominant species was Enterococcus faecium, resistant to vancomycin and carbapenems, with the VanA phenotype being most common. These findings emphasize the need for enhanced infection control measures and antimicrobial stewardship to combat VRE and improve patient outcomes.
It’s crucial to understand that Enterococci’s genetic resistance to many antimicrobials, specifically vancomycin, an antibiotic once very effective against these bacteria, has increased globally. Added to this, VRE are a prevalent pathogen amongst hospitalized patients, causing considerable morbidity, mortality and increased hospital costs.
Due to inherent weaknesses such as lowered immunity, indwelling catheters, abdominal surgery, and heavy antimicrobial use, VRE infections are particularly prevalent amongst ICU patients. Notably, patients within this demographic who also suffer from conditions such as chronic heart failure, malignancies, insulin-dependent diabetes, and previous enterococcal infections are particularly vulnerable.
In conclusion, considering the rapidly increasing prevalence and significant mortality rate associated with VRE infections, it’s evident these superbugs pose a severe challenge to healthcare professionals. Therefore, continuously enhancing infection prevention practices and antimicrobial stewardship programs are key priorities for healthcare facilities across the globe.