Change in the Prevalence and the Antibiotic Resistance of the Enterococcal Species Isolated from Blood Cultures

Abstract

Context : Blood stream infections are an important cause of mortality and morbidity. Enterococci have become increasingly resistant to a wide range of antimicrobial agents and enterococcal bacteraemia results in a high mortality of about 54%. Aim : The present study was done to determine the prevalence of different enterococcal species in blood stream infections and their anti-microbial resistance, with a special reference to vancomycin and high level aminoglycoside resistance. Material and methods : The study was conducted on 50 enterococcal blood isolates. The isolates were identified by using standard microbiological techniques and antimicrobial susceptibility testing was done by the Kirby Bauer disc diffusion method according to the CLSI guidelines. Results : The maximum numbers of enterococci were isolated from male patients of the age group of 0-20 years. Most of the enterococcal isolates (78%) were non-haemolytic and multidrug resistant. E.faecium (70%) was the predominant species which was isolated. Linezolid showed good antienterococcal activity. Vancomycin resistance was seen in 6 (12%) isolates and high level aminoglycoside resistance was seen in 20 (40%) isolates. The E.faecium isolates were more drug resistant than the E.faecalis isolates. Conclusion : Steps should be taken to regularly screen the enterococcal isolates for vancomycin and high level aminoglycoside resistance and to treat the enterococcal infections effectively to limit the spread of multidrug resistant enterococcal infections.

Keywords

• enterococcus
• vre
• e.faecium
• high level aminoglycoside resistance
• enterococcal bacteremia.