Aim:
Objective: To study local epidemiology, antimicrobial susceptibility patterns, and clinical outcomes of VRE infections among inpatients.

Material and methods:
Methods: A retrospective observational study was carried out on all patients admitted with culture-confirmed Vancomycin-resistant enterococci infections between July 2025 and January 2026 in Najaf, Iraq. Data on demographic characteristics, clinical information, antimicrobial exposure, microbiological findings, and outcomes were obtained from medical records.

Results:
Results: A total of 84 patients with Vancomycin-resistant enterococci infection were included. Mean age was 56 ± 18 years, and 57.1% were male. Prior antibiotic exposure was seen in 75.0% of patients, while 33.3% had previously received Vancomycin therapy. Enterococcus faecium was the predominant species 73.8%, followed by Enterococcus faecalis 21.4%. All isolates were resistant to Vancomycin, while resistance rates against ampicillin, ciprofloxacin, and high-level gentamicin were 70.2%, 63.1%, and 52.4% respectively. Susceptibility to linezolid and daptomycin was still high (97.6% and 98.8% respectively). Urine was the most common specimen source 40.5%, followed by blood cultures 26.2%. In terms of clinical outcomes, 36.9% were admitted to the ICU, 26.2% had a bloodstream infection, 21.4% needed mechanical ventilation, 14.3% had septic shock, and there was an overall mortality rate of 23.8%.

Conclusions:
Conclusion: infections due to Vancomycin-resistant enterococci impose a huge healthcare burden in our setting; E. faecium is the leading species and is multidrug resistant. It was, however, associated with significant mortality despite preserved susceptibility to linezolid and daptomycin. Therefore, continuous surveillance coupled with antimicrobial stewardship and strict infection control practices is needed to contain the spread and impact of VRE infections.