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Volume 12 Issue 2 ( April- June) 2023

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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