DISCUSSION

Glycopeptide-resistant enterococci have become a major threat to hospitalized patients. Like methicillin-resistant Staphylococcus, VRE can cause important nosocomial epidemics and can, increase morbidity, mortality, and costs related to admission to hospitals. The emergence of VRE has resulted in an increase in the incidence of infections that are caused by these organisms and that cannot be treated with currently available antimicrobial agents, and have caused serious concerns to both physicians and health authorities. Enterococci are the second most common cause of nosocomial infections in the United States and are responsible for approximately 8% of all nosocomial bloodstream infections. Numerous reports have appeared on the serious infections and mortality associated with enterococcal strains particularly E. faecium, especially among immunosuppressed patients or those with underlying illnesses.

The purpose of this thesis is to isolate enterococci with acquired resistance to antibiotics and to generate data on the occurrence of enterococci in Gaza City. Antibiotic resistance patterns of the isolated enterococci were assessed, the carrier rates of VRE in hospitalized patients and non-hospitalized individuals in Gaza city were investigated, VRE species were identified and risk factors associated with VRE were studied. Proper use of vancomycin by the physicians was evaluated.