PREVALENCE AND ANTIBIOTIC SUSCEPTIBILITY PATTERN OF ENTEROCOCCUS ISOLATES FROM CLINICAL SAMPLES AT A TERTIARY CARE CENTRE IN WESTERN MAHARASHTRA, INDIA

Anjan Trivedi, Aditi Sondhi, Mahima Lall*, Kavita Bala Anand and Nandita Hazra

ABSTRACT

Introduction: Enterococci are normal commensals of the gastrointestinal tract. They are one of the leading causes of nosocomial urinary tract infections. They are opportunistic pathogens harbouring antibiotic resistance genes which may lead to treatment failures. Aim: To determine the prevalence and antibiotic susceptibility pattern of Enterococcus isolates in clinical samples. Materials and Methods: Consecutive, non-repeat Enterococcus isolates (264), from clinically relevant samples (28,945 of them) received at a tertiary care centre during the study duration (01 May 2018 to 31 Oct 2020) were included in this retrospective laboratory-based study. Identification of positive cultures was done by phenotypic and automated methods by Vitek 2 Compact Bacterial Identification System (BioMerieux). The antibiotic susceptibility testing was done by automated and Kirby-Bauer disk diffusion methods according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: A total of 264 Enterococcus isolates were identified during study duration. The distribution of these isolates in different clinical samples was; urine (1.42%), pus (1.01%), blood (0.18%) and miscellaneous samples including body fluids (0.79%). The species were Enterococcus faecalis (46.2%), Enterococcus faecium (33.3%) and unspeciated Enterococci (19.3%). 57.6% of these isolates were obtained from ward patients, and 13.6% and 28.8% from Intensive Care Unit (ICU) and Outpatient Department (OPD) patients respectively. A maximum number of isolates were susceptible to Teicoplanin (93.0%) and Linezolid (92.0%), Fosfomycin (88.4%), Vancomycin (84.2%), Nitrofurantoin (77.9%), and High-Level Aminoglycosides (HLA); Gentamicin (55.2%) Streptomycin (57.5%). Conclusion: Enterococcus strains were found to be least resistant to Teicoplanin. Hospital wards were the commonest place of spread of infection. Pan-resistant, multidrug resistant and glycopeptide resistant Enterococci were noted in this study.

Keywords: Enterococci, Antibiotic susceptibility, Glycopeptides.