Original Articles
Analysis of susceptibility pattern of Enterococcus species from Urinary tract infections with special reference to High level Aminoglycosides and Vancomycin | |
Dr. Parasmita Das Choudhury, Dr. Kalpana Bezborah | |
Background: Enterococci are one of the important causes of nosocomial urinary tract infections. The emergence of High-level Aminoglycoside Resistance (HLAR) and Vancomycin-Resistant Enterococci (VRE), have complicated the available treatment modalities for enterococci worldwide. Objectives: To determine the prevalence of Enterococcus species causing urinary tract infections and their antimicrobial susceptibility pattern in a tertiary care centre with special emphasis on high level aminoglycosides and vancomycin resistance. Methods: A total of 2405 urine samples were processed by standard protocol. All Enterococci identified, were further speciated and the antibiogram was determined by Kirby-Bauer disk diffusion method as per CLSIguidelines. Minimum inhibitory concentration (MIC) for vancomycin was determined by the Epsilometer test. Data were analyzed using SPSS version 20 and p≤ 0.05 was considered as significant. Results: Of 104 (4.53%) enterococcal isolates, 48 (46.1%) were identified as Enterococcus faecalis, 42 (40.4%) as Enterococcus faecium and 14 (13.5%) as Enterococcus avium. Overall, antibiogram of the isolates showed high resistance to norfloxacin (79.8%), ciprofloxacin (77.9%) and levofloxacin (74%). HLAR was observed in 53 (51%) isolates, significantly higher in E. faecium than E. faecalis (p=0.008). High-level Gentamicin resistance (HLGR) was seen in 41.3% cases and high-level Streptomycin resistance (HLSR) was seen in 34.6%. Occurrence of VRE in our setting was 1.9%. Multidrug resistance (MDR) was observed in 25.9% isolates. Conclusions: The study highlights the alarming rise in prevalence of MDR enterococci, especially to high level aminoglycoside, which warrants immediate, adequate, and efficient surveillance program to prevent and control its spread. |
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