Emerging crisis of multidrug-resistant enterococci from a rural tertiary care hospital of North India

Abstract

INTRODUCTION: Enterococci are emerging as a major pathogen causing a variety of hospital-acquired nosocomial infections and community-acquired infections contributing significantly to patient's morbidity and mortality. The emergence of multidrug-resistant enterococci worsens the problem as multidrug resistance leaves fewer therapeutic options for clinicians in treating life-threatening infections. MATERIALS AND METHODS: This was an observational study carried out from March 2019 to February 2020. Antimicrobial susceptibility testing of enterococci was done by Kirby–Bauer disc diffusion method, and results were interpreted as per the Clinical and Laboratory Standards Institute guidelines 2019. RESULTS: Multidrug-resistant enterococci were reported to be 62.7%. A variable antimicrobial susceptibility pattern was seen with different antibiotics. Majority of isolates were resistant to β-lactam (96.6%), and high-level aminoglycoside resistance was seen in 39% of isolates. Glycopeptide resistance was observed in teicoplanin (14.6%). No vancomycin and linezolid resistance was noted. CONCLUSION: The prevalence of multidrug-resistant enterococci was reported to be 63%; the resistance was more common in Enterococcus faecium as compared to Enterococcus faecalis. This study highlights the emergence of multidrug-resistant enterococci, especially to high-level aminoglycoside and glycopeptide which poses a serious therapeutic challenge.

Keywords

• antimicrobial susceptibility testing
• high-level aminoglycoside resistance
• minimum inhibitory concentration and multidrug-resistant enterococci