الفهرس 
AcknowledgmentOnly 14 pages are availabe for public view
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Abstract
This study was carried out on 108 patients admitted to the trauma, general and post-operative ICUs at Assiut University Hospitals, over ten-months period from October 2014 to July 2015. Three hundred and six (306) specimens were collected from the different ICUs as follows: 202 from the trauma ICU, 84 from the general ICU and 20 from the post-operative ICU. The studied samples included 67 sputum samples, 65 endotracheal aspirates, 64 urine samples, 44 blood samples, 34 wound swabs and 32 throat swabs.
One hundred and twenty enterococci were identified by conventional manual methods and were assigned to the species level using the Vitek®2 Compact system. 42 enterococci were isolated from urine samples (35.0%), 24 (20.0%) from endotracheal aspirates, 19 (15.83%) from blood samples, 15 (12.50%) from sputum samples, 14 (11.67%) from throat swabs and six from wound swabs (5.0%). E. faecalis was the most isolated species (53.3%) followed by E. faecium (30%), E. gallinarum (11.7%) and E. casseliflavus (5%).
Antibiotic susceptibility testing to vancomycin was assessed by the conventional agar screen test and by the Vitek®2 Compact system. 74 (24.2%) isolates were found to be resistant to vancomycin while 46 (15.0%) were found to be sensitive. VRE isolates were identified to the species level as follows E. faecalis (59.46%) followed by E. faecium (18.92%), E. gallinarum (13.51%) and E. casseliflavus (8.11%). VRE were isolated most frequently from endotracheal aspirates (24.3%), followed by blood (23%), urine (17.6%), throat swabs (14.9%), sputum (12.2%) and wound swabs (8.1%).
Antibiotic susceptibility testing showed that the isolated enterococci were most resistant to streptomycin (95%), tetracycline (80.8%), erythromycin (78.3%), gentamycin (77.5%), ciprofloxacin (69.2%), benzyl penicillin (49.2%) and ampicillin (47.5%). The least resistance was for linezolid (6.7%). None of the isolates was resistant to tigecycline.
Glycopeptide resistance phenotypes and genotypes were detected by antibiotic susceptibility testing to vancomycin and teicoplanin and by multiplex PCR assay, respectively. Regarding phenotypes, 41 (55.41%) isolates were found to be Van A, 20 (27.03%) were Van B, while 13 (17.57%) were Van C. As for the genotypes, 56 of the VRE isolates (75.68%) were found to harbor the vanA gene, 2 (2.70%) vanB gene and 16 (21.62%) vanC1 gene. The vanC-2/3 was not found in any of the isolates.
Fifteen isolates with vanA genotype but exhibiting VanB phenotype (VanB phenotype–vanA genotype incongruence) (20.27%) were detected.