Intestinal carriage of vancomycin-resistant enterococci in a community setting in Casablanca, Morocco

Abstract

This study aimed to determine the rate of intestinal carriage of vancomycin-resistant enterococci (VRE) and to perform a phenotypic and genotypic characterisation of VRE isolates in the community in Casablanca, Morocco. During 6 months in 2014, 113 faecal samples were examined for the presence of enterococci. Antibiotic susceptibility of the isolates was determined by the disk diffusion method. Phenotypic and genotypic species identification was performed, and the vanA, vanB and vanC genes were detected by PCR. Each bacterial isolate resistant to vancomycin was subjected to amplification and sequencing of the 16S rRNA gene. In total, 100 strains were collected from a community population of 80 persons; 55% of the isolates were identified as Enterococcus faecium and 45% as Enterococcus faecalis. The resistance profile showed that 88% of the strains were multiresistant. The rate of faecal carriage of VRE was 21% (n=21), among which 8 strains were E. faecalis (17.8% of all E. faecalis) and 13 strains were E. faecium (23.6% of all E. faecium). PCR analysis revealed that all of the strains were resistant to vancomycin owing to possession of the vanA gene. The emergence of VRE and the high rate of colonisation by multiresistant enterococci are alarming. Strict measures are required to control the further spread of these strains in the Moroccan community.

Keywords: Enterococcus; Intestinal carriage; Moroccan community; Resistance; Vancomycin.