Title: MDR Enterococci- Race for Supremacy between Enterococci and Antibiotics
Authors: Dr Jyoti P. Sonawane, Dr Rita Swaminathan, Dr Nadeem A.L. Ameen
DOI: https://dx.doi.org/10.18535/jmscr/v5i2.129
Abstract
Introduction: Enterococci, considered a normal commensal of intestinal tract, are fast emerging as a pathogen causing serious and life threatening hospital borne infections. During the last few years, enterococci have acquired resistance to a number of important antibiotics like Penicillin, Aminoglycosides including glycopeptides which pose a serious challenge not only for clinicians but also for health care institutions. It results in treatment failure, selection and spreading of resistant strains in the health care institution.
Aims & Objective: In view of this, the present study was undertaken to know the prevalence of multi drug resistant Enterococcus Species with special reference to Vancomycin.
Materials & Methods: During the study period of 6 months from January 2015 to June 2015, from 3131 clinical samples received by Microbiological laboratory, 207(6.61%) Enterococci were isolated and identified by using standard microbiological techniques and their antimicrobial susceptibility was performed according to CLSI guidelines. E-test was performed on Vancomycin resistant strains to detect the MIC of Vancomycin.
Results: Out of 3131 samples, 207(6.61%) samples were positive for Enterococcal species. of which 123 (59.42%) isolates were E.faecalis, 55(26.57%) E.faecium, & 29 (14.01%) other Enterococcus Spp. Maximum isolation was from Urine 143(69.08%) followed by Pus 43(20.77%) and 08(3.86%) broncho-alveolar lavage samples. 102 (49.28%) isolates were multidrug resistant Enterococci. Of which 52(50.98%) were MDR E.faecium and 50 (49.02%) MDR E.faecalis. Two isolates, both urine samples and Vancomycin resistant (VRE), were Entercoccus faecium. They showed (100%) sensitive to Linezolid, (99.03%) sensitivity to Vancomycin. Other resistant drugs in our study were Nitrofurantoin (60.84% used only in urinary isolates), Amikacin (74.40%), Gentamicin(74.88%), Ciprofloxacin (78.74%), Erythromycin (82.61%) and Penicillin (93.72%).
Conclusion: Empirical therapy for Enterococcal infections should be guided by local patterns of drug resistance. Regular screening of Enterococcal isolates for Vancomycin resistance detection should be implemented along with the infection control measures, screening of health care workers and surveillance of cultures which can control spread of multidrug resistant Enterococci.
Keywords: Enterococci, Multidrug resistant (MDR), E-Test, Vancomycin.
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