Characterization of Enterococci Causing Nosocomial Infections at the Jordan University Hospital Over a Five-year Period

Azmi M. Mahafzah, Ilham B. Abu-Khader, Faris G. Bakri


Objectives: This study was carried out to determine the relative frequency, antimicrobial susceptibility, and species distribution of enterococci causing nosocomial infections at the Jordan University Hospital (JUH) over a 5 year period.

Methods: Presumptive identification of Enterococci was followed by species determination using the Crystal Identification System. Antimicrobial susceptibility was determined using the E-Test, and PCR was used to confirm species identification and determine Vancomycin resistance genotype.

Results: Enterococci were responsible for 8.4% of nosocomial infections detected in the study period, the majority of which were associated with wound and urinary tract infections. Enterococcus faecalis was the species most frequently isolated being responsible for 83% of infections, whereas Enterococcus faecium caused 16% of infections. The majority of isolates were resistant to tetracycline and gentamicin with no notable species differences. Resistance to ampicillin and levofloxacin was, however, twice as common among E. faecium as compared to that among E. faecalis.

Conclusions: The most important finding of this study is the detection of vancomycin resistance among enterococci. It is critical to realize that resistance to the usual first choice of treatment, ampicillin, is common in Jordan and that resistance to alternative treatments has emerged.


Nosocomial infections, Enterococci, VRE, antimicrobial susceptibility

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