VRE ENTEROCOCCI CARRYING VANA GENE IN PUBLIC HOSPITALS FROM RECIFE.

André Luiz Silva Paes Barreto (FAFIRE); Kássia Karoline Aliança de Castro (UPE); Lidya Ângelo Alves Bezzera (UPE); Felipe Lira de Sá Cavalcanti (UPE); Anna Carolina Soares Almeida (UPE); Marinalda Anselmo Vilela (UPE); Márcia Maria Camargo de Morais (UPE)

Enterococci are important pathogens of nosocomial infections, which provide serious limitations due to cumulative resistance to antimicrobial agents. Since its first discovery, vancomycin-resistant enterococci (VRE) have been reported worldwide. The most common phenotype is known as the VanA, which is characterized by acquired inducible and high-level resistance to vancomycin and teicoplanin. Recently, an outbreak of VRE showing VanA phenotype was identified in two public hospitals in Recife, Pernambuco. This work aims to detect the van A gene and to identify the Enterococcus species from two outbreaks in public hospitals in Recife, Brazil. Ten isolates resistant to vancomycin, 5 from each public hospital, were analised. The bacterial isolates were collected and identified by the routine microbiological laboratory of the both hospitals. Antimicrobial susceptibility was determined by disk-diffusion method, using the criteria of CLSI (2007), and the following antibiotics were tested: ampicillin, chloramphenicol, linezolid, penicillin, teicoplanin, vancomycin, gentamicin and streptomycin.  Specific PCR was performed for detection of vanA gene and identification of  Enterococcus species. Results showed that all the samples were identified as Enterococcus faecium, all of them carrying the vanA gene. Suceptibility tests showed that 100% were resistant to ampicillin, penicillin, vancomycin and teicoplanin, while 100% were sensitive to chloramphenicol and linezolid. High levels of resistance to streptomycin and gentamycin were also detected. It was concluded that both hospitals presented Enterococcus faecium, harbouring vanA gene with high levels of glycopeptide resistence, suggesting the transfer of this gene between the two hospitals. For confirming this hypothesis, genotyping approach will be carried out.