Study of Prevalence and Antimicrobial Susceptibility Pattern of Enterococci Isolated from Clinically Relevant Samples with Special Reference to High Level Aminoglycoside Resistance (HLAR) in a Rural Tertiary Care Hospital...

ABSTRACT

Enterococci are important human pathogens that cause many infections including nosocomial infections. Some important clinical infections caused by Enterococcus species are urinary tract infections, bacterial endocarditis, genital tract infections, surgical wound infections, bacteraemia and meningitis.Around, 80 - 90% of infections are commonly caused by E. faecalis followed by E. faecium with a contribution of about 10 - 15% along with emergence of multi-drug resistance (MDR) including to vancomycin. Enterococci have developed both intrinsic and acquired resistance towards many antibiotics including to high level aminoglycosides. This short term project was undertaken to study the prevalence and antibiotic susceptibility (AST) pattern of Enterococcus species isolated from clinical specimen with special reference to high level aminoglycoside resistance (HLAR) in a rural tertiary care hospital. Methods100 Enterococci isolated from clinically relevant samples were identified according to standard procedures and AST was carried out according to CLSI guidelines. ResultsOut of 100 enterococci, 70 E. faecalis, 21 E. faecium and 09 other Enterococcus species were isolated. The results showed that majority of enterococci was isolated from >60 age group (37%), from male patients (59%), from urine samples (59%) and from medicine department (36%). AST showed overall high resistance to Penicillin (98%) Ampicillin (86%), Gentamicin (85%), Ciprofloxacin (60%), Vancomycin (12%) (VRE), high level gentamicin (42%) (HLGR) and high level streptomycin (34%) (HLSR) and 15% isolates showed resistance to HLGR + HLSR. Multi drug resistance was seen in 40 (57.1%) E. faecalis isolates and 11 (52.3%) E. faecium isolates. Minimum resistance was observed with Linezolid (3%). ConclusionsThe present study showed high prevalence of antibiotic resistance in Enterococci. Hence, Enterococcus species isolated from samples should be routinely screened for HLAR, MDR and VRE so as to prevent the spread of multi drug resistant Enterococci and for proper selection of antibiotics.