PCR and routine assay was performed on all blood samples with different bacterial content. Results: Routine assay and PCR for all inoculated blood samples with ≥5 cfu/ml was positive. Mean time for PCR and routine assays was 10 hours and 5 days,

respectively. Conclusion: PCR is a more rapid and sensitive assay for simultaneous detection and characterization for Enterococcus faecalis, and determination of its sensitivity pattern to vancomycin. Key Words: Enterococcus faecalis, multiplex-PCR, Van A, Van B Introduction Inhibitors,research,lifescience,medical Enterococcus faecalis is the cause of 85-90% of enterococcal, and third cause of nosocomial infections, especially bacteremia, sepsis in children, endocarditis, urinary tract infection (UTI), and wound infections.1,2 It plays a significant role in Inhibitors,research,lifescience,medical treatment of the disease,3,4 Knowledge of bacterial resistance pattern to antimicrobial agents is important for the successful

management of diseases.5 Most hospital isolates are resistant to most usual antibiotics including vancomycin.6-8 There are five resistance genes whose products are responsible for resistance to glycopeptides antibiotics in vancomycin-resistant Inhibitors,research,lifescience,medical enterococci strains (VRE). Two of such genes (Van A and Van B) are most common than others, especially in E. faecalis and E. faecium.6,9 Strains with Van A gene are resistant to vancomycin and tycoplanin, and strains with Van B are resistant to vancomycin but sensitive to tycoplanin.10,11 Resistant enterococcal

infections are usually treated by synergistic action of a glycopeptide and an aminoglycoside.1,5 Vancomycin-resistant enterococci strains are usually transferred via the hands of health care workers, who are fecal carrier Inhibitors,research,lifescience,medical and are in close contact with patients. Those patients who have long-time hospital stay and long-time antibiotic therapy, as well as children and the elderly with a critical 5-FU situation, such as those who are hospitalized in intensive care units Inhibitors,research,lifescience,medical (ICU), are more prone to take the disease.12-14 Culture is the most-used way for detecting enterococci in the blood,2 however, for effective treatment of enterococcal bacteremia, characterization of the bacteria ADAMTS5 and their pattern of resistance to antibiotics is necessary. This requires some diagnostic biological tests as well as determination of its antibiogram pattern and MIC, which usually takes about five days.14-17 Some rapid methods such as E test for MIC, API 20 and API 32 for characterization, and selective-differential specific media and choromogenic agars for direct detection of VRE such as EVA, CAN-VGA, and BEAA with 6 µg/ml vancomycin have been introduced in recent years.15,18 These methods have shown different sensitivity and specificity in different studies,20-23 and need 2-3 days for final confirmation of their results.15,18,19 Therefore, a more rapid and reliable test is needed. PCR is reported to be a suitable alternative.