DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20173546

Characterization, speciation and antimicrobial resistance pattern of Enterococcus species isolated from clinical specimens at a rural tertiary care hospital

Shweta Jaiswal, Amit Singh, Rajesh K. Verma, Dharmendra P. Singh, Sunita Kumari

Abstract


Background: Enterococci have attracted much attention in recent years due to their increased recognition as a cause of nosocomial infection. They exhibit vancomycin resistance with increasing frequency so that determination of antimicrobial susceptibility pattern is necessary. Aim of present study is to determine the prevalence and susceptibility pattern of Enterococci in rural tertiary care hospital.

Methods: Total of 100 Enterococcus isolated from various clinical samples were identified and speciated by Vitek®2 compact system (BIOMERIEUX). Antibiotic susceptibility was determined by modified Kirby Bauer disc diffusion method. Results were interpreted as per CLSI guidelines and vancomycin MIC was determined by E-test method.

Results: Out of 100 Enterococcus strains 47 were E. faecalis, 51 were E. faecium, 02 were E. gallinarum and 01 was E. cassaliflavus. Resistance to penicillin, ampicillin, ciprofloxacin, elevated level gentamycin and high-level streptomycin were observed. All isolates were sensitive to linezolid and teicoplanin, 6% strains showed vancomycin resistance by E-test.

Conclusions: High rate of resistance to penicillin, ciprofloxacin and aminoglycosides is observed and emergence of VRE has further worsened this situation. So, there is an urgent need for more rational use of antimicrobials and infection control.


Keywords


Enterococcu, E-test, Vitek®2 compact system, VRE

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References


Jett BD, Huycke MM, Gilmore MS. Virulence of Enterococci. Clin Microbiol Rev. 1994;7:462-78.

Megran DW. Enterococcal endocarditis. Clin Infect Dis. 1992;15:63-71.

Murray BE. The life and times of Enterococci. Clin Microbial Rev. 1990;3:46-65.

Utley A, Collins C, Naidoo J, George R. Vancomycin resistant Enterococci. Lancet. 1988;1:57-8.

Udo EE, Al-Sweih N, Phillips OA, Chugh TD. Species prevalence and antibacterial resistance of Enterococci isolated in Kuwait hospitals. J Med Microbiol. 2003;52(2):163-8.

Mendiratta DK, Kaur H, Deotale V, Thamke DC, Narang R, Narang P. Status of high level aminoglycoside resistant Enterococcus faecium and Enterococcus faecalis in a rural hospital of central India. Indian J Med Microbiol. 2008;26(4):369-71.

Jain S, Kumar K, Kashyap B, Kaur IR. Clinico-epidemiological profile and high-level aminoglycoside resistance in enterococcal septicemia from a tertiary care hospital in East Delhi. Int J Applied and Basic Med Res. 2011;1(2):80-3.

Karmarkar MG, Gershom ES, Mehta PR. Enterococcal infections with special reference to phenotypic characterization and drug resistance. Indian J Med Res. 2004;119:22-5.

Telkar A, Baragundi MC, Raghavendra VP, Vishwanath G, Chandrappa N. Change in the prevalence and the antibiotic resistance of the Enterococcal species isolated from blood culture. J Clin and Diagnostic Res. 2012;6(3):405-7.

Bhat KG, Paul C, Bhat MG. Neonatal bacteraemia due to high level aminoglycoside resistant (HLAR) Enterococci. Indian J Pediatr. 1997;64:537-9.

Taneja N, Rani P, Emmanuel R, Sharma M. Significance of vancomycin resistant Enterococci from urinary specimens at a tertiary care centre in northern India. Indian J Med Res. 2004;119:72-4.

Descheemaeker P, Leven M, Chapelle S, Lammens C. Prevalence and molecular epidemiology of glycopeptides resistant Enterococci in Belgian renal dialysis. J Infect Dis. 2000;181:235-41.

Bekhit MM, Moussa IMI, Muharram MM, Alanazy FK, Hefni HM. Prevalence and antimicrobial resistance pattern of multidrug-resistant Enterococci isolated from clinical specimens. Indian J Med Microbiol. 2012;30(1):44-51.

Gonzales, RD, Schreckenberger PC, Graham MB, Kelkar S, DenBesten K, Quinn JP. Infections due to vancomycin-resistant Enterococcus faecium resistant to linezolid. Lancet. 2001;357:1179.

Marshall SH, Donskey CJ, Hutton-Thomas R, Salata RA, Rice LB. Gene dosage and linezolid resistance in Enterococcus faecium and Enterococcus faecalis. Antimicrob Agents Chemother. 2002;46:3334-6.