Speciation of Enterococcus species: better way to deal with clinical infections at resource limited settings

Kinjal P. Patel, Summaiya Mulla


Background: Enterococcus species are well known for its intrinsic resistance pattern to several antibiotics. Hence, appropriate management and prevention is essential in any healthcare facility. Present study was conducted to establish an accessible biochemical tests to differentiate Enterococcus species at resource limited settings.

Methods: Enterococci isolated from various clinical specimens were speciated using an array of biochemical reactions and antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion method. Results were interpreted as per Clinical and Laboratory Standards Institute (CLSI) guidelines.

Results: Out of 107 enterococcal isolates, 63(59%) were E. faecium, 40(37%) were E. fecalis, 2(2%) were E. hirae, 1(0.9%) was E. raffinosus and 1(0.9%) was E. gallinarum. E. faecium and E. fecalis showed 23% and 7% vancomycin resistance respectively, while E. gallinarum showed low level vancomycin resistance.

Conclusions: Enterococcus speciation can be done using simple biochemical reactions and its susceptibility pattern enables to distinguish Van phenotypes too. Hence, it is helpful for management of infections in resource limited settings to a greater extent.


Antimicrobial susceptibility, Biochemical reactions, Enterococcus, Phenotypes

Full Text:



Tendolkar PM, Baghdayan AS, Shankar N. Pathogenic Enterococci new development in 21stcentury. Cell Molecu Life Sci. 2003;60:2622-36.

Tyrrell GJ, Turnbull L, Teixeira LM, Lefebvre J, CarvalhoMda G, Facklam RR, et al. Enterococcus gilvus sp. nov. and enterococcus pallens sp. nov. isolated from human clinical specimens. J clin Microbiol. 2002;40:1140-5.

Murray BE. The life and times of the enterococcus. Clin Microbiol Rev. 1990;3:46-65.

Dutka MS, Evers S, Courvalin P. Detection of glycopeptide resistance genotypes and identification to the species level of clinically relevant enterococci by PCR. J Clin Microbiol. 1995;33:24-7.

Goedon S, Swenson JM, Hill BC, Pigott NE, Facklam RR, Cooksey RC, et al. Antimicrobial susceptibility patterns of common and unusual species of enterococci causing infections in the United States Enterococcal Study Group. J Clin Microbiol. 1992;30:2373-8.

Quinones D, Goni P, Carmen RM, Duran E, Gomez LR. Enterococci spp isolated from Cuba: species frequency of occurrence and antimicrobial susceptibility profile. Diag Microbiol Infect Diseas. 2005;51(1):63-7.

Teixara LM, Facklam RR, Steigerwait AG, Pigott NE, Merquior VL, Brenner DJ. Correlation between phenotypic characteristics and DNA relatedness within enterococcus faecium strains. J Clin Microbiol. 1995;33:1520-3.

Koneman EW, Allen SD, Janda WM, Schreckenberger PC, Winn WC. The gram positive cocci part II: streptococci, enterococci and the streptococci like bacteria. Color Atlas and Textbook of Diagnostic Micrbiology. 5th edition. New York: JB Lipincott; 1997:577-649.

Facklam RR, Collins MD. Identification of enterococcus species isolated from human infection by a convetional test scheme. J Clin Microbiol. 1989;27:731-4.

Clinical laboarotory standards institute. Performance standards for antimicrobial susceptibility testing: twenty second information supplement. Wayne, PA, USA.

Nischal M, Macaden R. Biochemical speciation and hemolytic activity in enterococci. Indian J Med Microbiol. 1996;14:205-8.

Gulati V, Aggarwal A, Khanna S, Narang VK. Biochemical speciation of enterococci causing human infections. Indian J Med Sci. 1997;51:310-2.

Devi PS, Rao PS, Shivananda PG. Characterization, antibiotic susceptibility pattern and detection of beta-lactamases in Enterococci. Indian J Pathol Microbiol. 2002;45:79-82.

Bhat KG, Paul C, Bhat MG. High level aminoglycoside resistance in enterococci isolated from hospitalized patients. Indian J Med Res. 1997;105:198-9.

Mohanty S, Jose S, Singhal R, Sood S, Dhawan B, Das BK, et al. Species prevalence and antimicrobial susceptibility of enterococci isolated in a tertiary care hospital of north India. Southeast Asian J Trop Med Public Health. 2005;36:962-5.

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.

Osoba AO, Jeha MT, Bakheshwain S, Anazi K, Bertlett F. Septicemia due to vancomycin-resistant enterococcus: a case report. Saudi Med J. 1995;16:67-9.

Mahafzah AM, Khader IB, Bakri FG. Characterization of enterococci causing nosocpmial infections at the Jordan University hospital over a five year period. J Med J. 2008;42:1-9.