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The present study aimed to determine the resistance mechanisms and clonal relationships among vancomycin-resistant Enterococci (VRE) isolated in AHEPA University Hospital during the pandemic year 2021. Overall, 140 clinical VRE were isolated during the study period and 44 were randomly selected for molecular analysis. A multiplex PCR was employed to detect vancomycin resistance genes (vanA, vanB, vanC, vanD, vanE, vanG) using specific primers. Additionally, pulsed-field gel electrophoresis (PFGE) was performed to assess the clonal relatedness of the selected isolates. The multiplex PCR showed that 36 of the 44 studied strains (81.9%) harbored the vanA gene whereas, 7 of 44 (15.9%) co-harbored the vanA and vanB resistance genes; one isolate had a negative PCR result. PFGE analysis unveiled 37 distinct electrophoretic patterns among the 44 VRE isolates with a similarity threshold of 75%. These patterns were clustered into 4 distinct branches. Our findings indicate a polyclonal distribution of vanA genes among the studied isolates and the notable concomitant presence of vanA/vanB genotypes. Furthermore, these results highlight the worsening that took place during the COVID-19 pandemic period regarding antibiotic resistance rates, underscoring the imperative need for stringent infection control measures and active surveillance.

Background: Laparoscopic liver resection offers a safe and feasible option primarily for the excision of hepatic neoplasms. Timely recovery of liver volume is a key factor for improving prognosis and post-operative mortality of patients undergone liver resection. The aim of the present study was to compare liver regeneration after laparoscopic over open partial hepatectomy., Methods: Wistar rats were subjected to laparoscopic 70% hepatectomy (group LAP-HEP), open 70% hepatectomy (group HEP), sham operation (group Sham) or no intervention (group Control). At various timepoints following operation (1 h-2 weeks), the liver was excised to assess relative liver weight, thiobarbituric acid reactive substances (TBARS) levels, mitotic activity, tissue expression of Nuclear Factor-κB (NFκB), Intercellular Adhesion Molecule-1 (ICAM-1) and Vascular Cell Adhesion Molecule-1 (VCAM-1) and the histopathologic profile., Results: No differences were seen in relative liver weight between hepatectomy groups. Mitotic index was increased in all operative study groups, being higher in group LAP-HEP than in group HEP. TBARS levels were higher in group LAP-HEP compared to group HEP. NFκB and VCAM-1 tissue expression scores were increased in all operative study groups with VCAM-1 being higher in group HEP, while ICAM-1 was overexpressed only in hepatectomy groups. Mild histopathologic lesions were noted in hepatectomy groups with the histopathologic score being higher in group HEP (24 h)., Conclusions: Laparoscopic liver resection enhanced hepatocyte mitotic activity which was accompanied by mild oxidative stress and a less pronounced local inflammatory response and tissue injury to that of the open technique.