Circulation of Vancomycin-Resistant Enterococci in Health Facilitiesof the Karachay-Cherkess Republic

Introduction. Gram-positive enterococci are an integral part of the normal intestinal microflora. However, if they get into wounds or sterile cavities of the body, they may induce various diseases including wound infections, urethritis, peritonitis, sepsis, pyelonephritis, or damage other organs. These microorganisms also induce nosocomial infections and are among the causative agents of health care-associated infections (HAIs); thus, it is critical to control the spread of enterococci. Our purpose was to monitor circulation of vancomycin-resistant enterococci (VRE) in health facilities of the Karachay-Cherkess Republic (KCR) in 2016-2018. Materials and methods. We studied VRE strains isolated in the Microbiological Laboratory of the Center for Hygiene and Epidemiology in the Karachay-Cherkess Republic. During three years, the total of 281 strains of vancomycin-resistant enterococci were isolated from various biological materials received from obstetric, surgical, pediatric, and therapeutic hospitals and from outpatients undergoing treatment in polyclinics of the Karachay-Cherkess Republic. Results. According to our data, VRE rates per 100 examined patients were 2.34 in 2016, 3.4 in 2017, and 3.03 in 2018, and were comparable to the rates registered in the Russian Federation in the range of 3% to 22.7%. Discussion. When analyzing circulation of vancomycin-resistant enterococci, we established that the highest VRE rate (4.24 per 100 examined patients) was observed in maternity hospitals, while the lowest rate of 0.67% was observed in therapeutic departments. When studying sensitivity of 281 isolated VRE strains to eight antibacterial drugs, no strain resistant to all antibiotics was revealed. Sensitivity to linezolid, ampicillin, and penicillin was observed in 92.6%, 79.0%, and 66.2% of strains. Sensitivity to ciprofloxacin, gentamicin, tetracycline, and nitrofurantoin was 50% or less. VRE were mainly isolated from urine and discharge from the cervical canal and pharynx.