Vancomycin Resistance among Enterococci: Further Limiting Our Therapeutic Options

ABSTRACT

Introduction: Enterococci are indigenous flora of theintestinal tract, oral cavity & genitourinary tract of human.Over recent years, there is increased interest in Enterococcinot only because of their serious infections but becauseof their increasing resistance to many antimicrobials.Vancomycin being the only alternative available. But over thetime, there has been increase in Vancomycin Resistance whichhas spread globally. The aim of this study was to determinethe prevalence of Vancomycin Resistant Enterococci (VRE)isolated from various clinical specimens in a tertiary carehospital in North India.Material and methods: A cross-sectional study was conductedin the Department of Microbiology, Government MedicalCollege, Amritsar from July 1st, 2018 to June 30th, 2019. Allthe samples received were processed and identification ofEnterococci was made by using standard microbiologicaltechniques. Antimicrobial susceptibility was performed byKirby Bauer disc diffusion method as per CLSI guidelines.Results: Out of total clinical samples (11,098), 3,551 (31.9%)were found to be culture positive. Among the culture positive,91 (2.56%) isolates were identified as Enterococcus speciescomprising of 37 E.faecalis (41%) and 54 E.faecium (59%).Maximum number of Enterococci were isolated from urinesamples (54.92%) followed by pus & body fluids (38.02%) andblood (7.04%). 9.52% of E.faecium isolates were found to beresistant to vancomycin. All the strains were 100% susceptibleto Linezolid, Teicoplanin & Quinupristin-dalfopristin.Conclusion: Enterococci have become the major pathogenicbacteria that cause hospital-acquired infections due tomultiple-antimicrobial resistance. VRE has emerged asimportant nosocomial pathogen and pose serious threat topatients. Vancomycin should be cautiously used else wewould be left with very few therapeutic options.