One of the major antibiotic-resistant pathogens presenting serious challenges to the health system is Vancomycin-Resistant Enterococcus (VRE). This bacterium, primarily manifesting in hospital environments, has robust colonization abilities and maintains longevity, posing a significant threat to human health. High standards of infection control methodologies are necessary to curb the spread of these pathogens, that also includes limiting antibiotic usage, particularly Vancomycin.
This article delves into a study that reported isolating VRE from samples of patients admitted to four Palestinian hospitals. During a five-year span from December 2020 to March 2024, 736 VRE isolates were detected, with 30 (4.76%) patients reported to have bacteremia. Emerging from this research is data analysis from hospitals situated in West Bank and East Jerusalem, inclusive of VRE prevalance in different body sites.
Enterococci are gram-positive facultative anaerobic bacteria, common species including Enterococcus faecalis and Enterococcus faecium. Present as normal flora in the gastrointestinal tract, they can cause severe infections like bacteremia, surgical site infection, urinary tract infection, and endocarditis. The World Health Organization has labeled VRE as a high-priority pathogen due to being responsible for estimated 30% of Enterococcus infections in hospital settings. Multiple factors can precipitate VRE outbreaks in hospitals, such as inadequate hand hygiene, exposure to broad-spectrum antibiotics, insufficient environmental hygiene, and non-compliance with infection control protocols.
This retrospective study reviewed four distinct healthcare facilities to evaluate the risk associated with positive surveillance culture cases in developing VRE bloodstream infections. A key finding was that Hospital 2 had the highest risk of bacteremia due to overall positive culture for VRE, largely attributed to the hospital having the highest percentage of positive rectal surveillance culture for VRE.
Infections caused by VRE are considered to be a significant drain on healthcare resources, with potential to transfer its vancomycin resistance to Staphylococcus aureus. They are prevalent among high-risk patients, such as those confined in intensive care units and immunocompromised individuals. Efficacy of control measures varied across all studied hospitals, leading to differing outcomes, further emphasizing the need for strict adherence to infection control protocols in all healthcare settings.
This study advocates for a multifaceted approach to VRE control including active surveillance, better hand and environmental hygiene, and careful antibiotics usage, particularly in high-risk environments.