Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

Users Online : 23668

Case report
Year : 2018 | Month : June | Volume : 12 | Issue : 6 | Page : DD03 - DD05

VanA Mediated Glycopeptide Resistant Enterococcus faecium (GRE) Infection in an Elderly Patient with Chronic Kidney Disease A Case Report

Martin Jane Esther, P K Rath, R Gopalakrishnan

1. Consultant and HOD, Department of Microbiology, Doctors' Diagnostic Centre, Trichy, Tamil Nadu, India. 2. Pathologist, Department of Pathology, Doctors' Diagnostic Centre, Trichy, Tamil Nadu, India. 3. Nephrologist, Department of Nephrology, Maruti Hospital, Trichy, Tamil Nadu, India.

Correspondence Address :
Dr. Martin Jane Esther,
C4, 10 B Cross, Thillai Nagar, Trichy-620018, Tamil Nadu, India.


A 66-year-old male patient who is a known case of chronic kidney disease was admitted to the hospital with complaint of seizures. He was uremic and showed signs of encephalopathy. He was previously hospitalized frequently and was on antitubercular treatment. A left sided radio cephalic fistula was made and the patient was on dialysis. Urinary catheter and central venous catheter were placed. Urine and blood cultures showed growth of Enterococcus faecium which was resistant to vancomycin Vancomycin Resistant Enterococci (VRE) or Glycopeptide Resistant Enterococci (GRE) by antibiotic susceptibility testing. The isolate was genotyped for detection of Van A, Van B and Van C genes and was found to harbour Van A gene. The treatment details of the patient and his outcome have been described. As Enterococci are inherently resistant to many drugs, their treatment is quite challenging. Combination therapy and de-escalation from broad spectrum antimicrobials to specific narrow spectrum antibiotics immediately after antibiotic sensitivity report is available which prevents emergence of drug resistance. Spread of VRE infection must be controlled by strict infection control methods as plasmid mediated rapid transfer of VRE can occur to other organisms like Staphylococci which is a serious threat.


Antibiotic susceptibility, Glycopeptide resistant Enterococci, Vancomycin resistant Enterococcus faecium

How to cite this article :

Martin Jane Esther, P K Rath, R Gopalakrishnan. VANA MEDIATED GLYCOPEPTIDE RESISTANT ENTEROCOCCUS FAECIUM (GRE) INFECTION IN AN ELDERLY PATIENT WITH CHRONIC KIDNEY DISEASE A CASE REPORT. Journal of Clinical and Diagnostic Research [serial online] 2018 June [cited: 2018 Jun 23 ]; 12:DD03-DD05. Available from

DOI and Others

DOI: 10.7860/JCDR/2018/35671.11614

Date of Submission: Jan 23, 2018
Date of Peer Review: Mar 17, 2018
Date of Acceptance: May 04, 2018
Date of Publishing: Jun 01, 2018


JCDR is now Monthly and more widely Indexed .
  • Emerging Sources Citation Index (Web of Science, thomsonreuters)
  • Index Copernicus ICV 2016: 132.37
  • Academic Search Complete Database
  • Directory of Open Access Journals (DOAJ)
  • EBSCOhost
  • Embase & EMbiology
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)